MEDICARE: DR. EDWARD BOEHRINGER 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	D4153	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083834204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD BOEHRINGER DDS

Provider Business Mailing Address
First Line	:	8151 E INDIAN BEND RD
Second Line	:	STE 111
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85250-4826
Country	:	US
Telephone Number	:	480-607-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1743 W PRINCE RD
Second Line	:	SUITE 115
City	:	TUCSON
State	:	AZ
Zip	:	85705-3092
Country	:	US
Telephone Number	:	520-408-2288
Fax Number	:

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

Provider Enumeration Date	:	04/27/2007
Last Update Date	:	01/13/2015

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