MEDICARE: DR. THOMAS HARVEY 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	1223G0001X	General Practice Dentistry	100950	CO

General Provider Information

NPI Number	:	1073537841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS HARVEY DDS

Provider Business Mailing Address
First Line	:	PO BOX 270638
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80527-0638
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	718 S COLLEGE AVE
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3301
Country	:	US
Telephone Number	:	970-224-4093
Fax Number	:

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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