MEDICARE: DR. FRANCISCO XAVIER VERAY IV D.D.S, M.S

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	4775015	WI
2	1223P0700X	Prosthodontics	002499	PR
3	1223P0700X	Prosthodontics	4775015	WI

General Provider Information

NPI Number	:	1356341580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCISCO XAVIER VERAY IV D.D.S, M.S

Provider Business Mailing Address
First Line	:	PSC 827 BOX526
Second Line	:
City	:	FPO AE
State	:	AL
Zip	:	09619
Country	:	US
Telephone Number	:	81-629-5853
Fax Number	:	81-629-5853

Provider Business Practice Location Address
First Line	:	NMRTC QUANTICO
Second Line	:	3259 CAITLIN AVE.
City	:	QUANTICO
State	:	VA
Zip	:	22134
Country	:	US
Telephone Number	:	703-432-1443
Fax Number	:

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	04/02/2024

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