Kyle Scott, DDS

Individual provider Active NPI General Practice Dentistry · Bicknell, IN

NPI 1578092292 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1578092292
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12012697A (IN)
Practice address
302 Washington St
Bicknell, IN 47512-1812
Phone
(812) 735-2754
NPI assigned
Jun 6, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12012697AINMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12012697A IN Yes

Addresses

Primary practice location

302 Washington St
Bicknell, IN 47512-1812

Mailing address

302 Washington St
Bicknell, IN 47512-1812
Phone (812) 735-2754

Other providers in Bicknell, IN

All providers in Bicknell, IN · General Practice Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.