Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 8698 | CO |
NPI | 1124111406 |
---|---|
Provider Name | Dr. Scott Allan Draper |
First Address | Colorado Springs, CO 80920-2404 |
Second Address | Colorado Springs, CO 80920-3932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2006 |
Last Update Date | 08/07/2007 |