Scott Gorden Stafford, Dds, PC

NPI #1093004467 in Live Oak, Texas

Provider Information

NPI Number: 1093004467
Entity Type: Organization
Organization Name: Scott Gorden Stafford, Dds, PC
Primary Specialty: Dentist
Enumeration Date: Apr 6, 2011
Last Updated: Apr 6, 2011

Practice Location

Address: 12501 JUDSON RD
Address 2: SUITE 101
City: Live Oak
State: Texas
ZIP Code: 78233-4103
Phone: (210) 599-9610

Authorized Official

Name: DR. SCOTT G STAFFORD, DDS
Title: PRESIDENT
Phone: (210) 599-9610

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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