Provider Demographics
NPI:1811283369
Name:SCOTT C. NORD D.M.D M.S P.C
Entity type:Organization
Organization Name:SCOTT C. NORD D.M.D M.S P.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:C
Authorized Official - Last Name:NORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-225-7141
Mailing Address - Street 1:291 E UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-7638
Mailing Address - Country:US
Mailing Address - Phone:801-225-7141
Mailing Address - Fax:801-225-0551
Practice Address - Street 1:291 E UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-7638
Practice Address - Country:US
Practice Address - Phone:801-225-7141
Practice Address - Fax:801-225-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5342094-99211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty