MEDICARE: DR. MARY ELLEN ARGUS 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	12008540A	IN

General Provider Information

NPI Number	:	1164627857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY ELLEN ARGUS DDS

Provider Business Mailing Address
First Line	:	1527 SYCAMORE HILLS PKWY
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46814-9343
Country	:	US
Telephone Number	:	260-625-5424
Fax Number	:

Provider Business Practice Location Address
First Line	:	6427 GEORGETOWN NORTH BLVD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-7007
Country	:	US
Telephone Number	:	260-486-4444
Fax Number	:

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

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	02/08/2010

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