MEDICARE: FRANCIS MICHAEL OMALLEY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DI12454	NJ

General Provider Information

NPI Number	:	1003909250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCIS MICHAEL OMALLEY DDS

Provider Business Mailing Address
First Line	:	1760 WHITEHORSE HAMILTON SQUARE ROAD
Second Line	:	SUITE 3
City	:	HAMILTON
State	:	NJ
Zip	:	08690-3535
Country	:	US
Telephone Number	:	609-588-0077
Fax Number	:	609-588-0129

Provider Business Practice Location Address
First Line	:	1760 WHITEHORSE HAMILTON SQUARE ROAD
Second Line	:	SUITE 3
City	:	HAMILTON
State	:	NJ
Zip	:	08690-3535
Country	:	US
Telephone Number	:	609-588-0077
Fax Number	:	609-588-0129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/08/2007

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