Provider Demographics
NPI:1164884243
Name:SCOTT, JOHN C (DDS)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:4301 W MARKHAM ST # 624
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-526-7619
Practice Address - Fax:501-526-4544
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR4115122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist