Provider Demographics
NPI:1750381000
Name:SCOTT, TERRY J (DMD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:J
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 LOY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-1726
Mailing Address - Country:US
Mailing Address - Phone:903-892-1200
Mailing Address - Fax:903-813-1581
Practice Address - Street 1:2801 LOY LAKE RD
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-1726
Practice Address - Country:US
Practice Address - Phone:903-892-1200
Practice Address - Fax:903-813-1581
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179681223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1209090Medicaid
TX88D756OtherBLUE CROSS