Provider Demographics
NPI:1881740199
Name:TAM, SCOTT F (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:F
Last Name:TAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-5607
Mailing Address - Country:US
Mailing Address - Phone:626-914-1888
Mailing Address - Fax:
Practice Address - Street 1:413 E ARROW HWY
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-5607
Practice Address - Country:US
Practice Address - Phone:626-914-1888
Practice Address - Fax:626-963-1508
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA354561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice