Mortimer, Scott Allen

Mortimer, Scott Allen is an individual health care provider with primary practice located at 4495 S Center Rd , Burton MI 48519-1417. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mortimer, Scott Allen can be contacted via phone (810) 743-5131.

Contact Information

Primary practice address
4495 S Center Rd Burton MI 48519-1417
Phone: (810) 743-5131
Fax: (810) 743-1111
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2901014445 Michigan

Profile Details

NPI number 1861439978
LBN Legal business name Mortimer, Scott Allen
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861439978 NPPES
Michigan MEDICAID 2917015

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