Provider Demographics
NPI:1669876850
Name:JAMES R SCOTT DDS
Entity type:Organization
Organization Name:JAMES R SCOTT DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:A PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:970-323-6828
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:CO
Mailing Address - Zip Code:81425-0528
Mailing Address - Country:US
Mailing Address - Phone:970-323-6828
Mailing Address - Fax:970-323-6186
Practice Address - Street 1:601 MAIN ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:CO
Practice Address - Zip Code:81425
Practice Address - Country:US
Practice Address - Phone:970-323-6828
Practice Address - Fax:970-323-6186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-16
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106268261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental