MEDICARE: DR. DAVID ALAN FOREMAN 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	122300000X	Dentist	0390541	NY

General Provider Information

NPI Number	:	1336327808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ALAN FOREMAN DMD

Provider Business Mailing Address
First Line	:	1021 BRIERWOOD BLVD
Second Line	:
City	:	SCHENECTADY
State	:	NY
Zip	:	12308-2907
Country	:	US
Telephone Number	:	518-372-4437
Fax Number	:	518-372-1425

Provider Business Practice Location Address
First Line	:	1021 BRIERWOOD BLVD
Second Line	:
City	:	SCHENECTADY
State	:	NY
Zip	:	12308-2907
Country	:	US
Telephone Number	:	518-372-4437
Fax Number	:	518-372-1425

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

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	02/06/2008

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