MEDICARE: MICHAEL F. ALSPAUGH

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	5007	OK

General Provider Information

NPI Number	:	1215194162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL F. ALSPAUGH

Provider Business Mailing Address
First Line	:	609 S KELLY AVE
Second Line	:	SUITE A1
City	:	EDMOND
State	:	OK
Zip	:	73003-5659
Country	:	US
Telephone Number	:	405-340-3880
Fax Number	:	403-341-3630

Provider Business Practice Location Address
First Line	:	609 S KELLY AVE
Second Line	:	SUITE A1
City	:	EDMOND
State	:	OK
Zip	:	73003-5659
Country	:	US
Telephone Number	:	405-340-3880
Fax Number	:	405-341-3630

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL F ALSPAUGH
Credential	:	D.D.S.
Telephone Number	:	405-340-3880

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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