Provider Demographics
NPI:1811077381
Name:OSTLER, M SCOTT (DDS, MSD)
Entity type:Individual
Prefix:
First Name:M SCOTT
Middle Name:
Last Name:OSTLER
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 JADWIN AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2902
Mailing Address - Country:US
Mailing Address - Phone:509-943-2505
Mailing Address - Fax:509-943-9072
Practice Address - Street 1:1520 JADWIN AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2902
Practice Address - Country:US
Practice Address - Phone:509-943-2505
Practice Address - Fax:509-943-9072
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA66741223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics