MEDICARE: DR. DAVID GENE UCHIDA DMD

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	ORE5400	OR

General Provider Information

NPI Number	:	1336147420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID GENE UCHIDA DMD

Provider Business Mailing Address
First Line	:	345 SW 4TH ST
Second Line	:
City	:	ONTARIO
State	:	OR
Zip	:	97914-2640
Country	:	US
Telephone Number	:	541-889-8363
Fax Number	:

Provider Business Practice Location Address
First Line	:	345 SW 4TH ST
Second Line	:
City	:	ONTARIO
State	:	OR
Zip	:	97914-2640
Country	:	US
Telephone Number	:	541-889-8363
Fax Number	:

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

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