Provider Demographics
NPI:1144433079
Name:SCOTT, CHAD EDWARD (DDS)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:EDWARD
Last Name:SCOTT
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 1:207 CRAWFORD CT
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-4065
Mailing Address - Country:US
Mailing Address - Phone:724-831-6692
Mailing Address - Fax:
Practice Address - Street 1:12590 PERRY HWY STE 100
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-1547
Practice Address - Country:US
Practice Address - Phone:724-713-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0367741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice