Provider Demographics
NPI:1740301670
Name:YOUNG, CHARLES SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:SCOTT
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6769 LAKE WOODLANDS DR STE G
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2770
Mailing Address - Country:US
Mailing Address - Phone:281-367-5559
Mailing Address - Fax:281-465-8737
Practice Address - Street 1:6769 LAKE WOODLANDS DR STE G
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2770
Practice Address - Country:US
Practice Address - Phone:281-367-5559
Practice Address - Fax:281-465-8737
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19834122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist