Provider Demographics
NPI:1780477232
Name:SCOTT A. THAYER DDS, MS, PLLC
Entity type:Organization
Organization Name:SCOTT A. THAYER DDS, MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:THAYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:254-374-6680
Mailing Address - Street 1:2419 PALERMO PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3790
Mailing Address - Country:US
Mailing Address - Phone:254-374-6680
Mailing Address - Fax:
Practice Address - Street 1:2419 PALERMO PKWY STE 110
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3790
Practice Address - Country:US
Practice Address - Phone:254-374-6680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty