Provider Demographics
NPI:1780740787
Name:SCRUGGS, FARRELL GENE (DDS)
Entity type:Individual
Prefix:DR
First Name:FARRELL
Middle Name:GENE
Last Name:SCRUGGS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:FARRELL
Other - Middle Name:G
Other - Last Name:SCRUGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1093 ELKINS LK
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-8831
Mailing Address - Country:US
Mailing Address - Phone:817-937-6299
Mailing Address - Fax:
Practice Address - Street 1:1093 ELKINS LK
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-8831
Practice Address - Country:US
Practice Address - Phone:817-937-6299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12063122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist