MEDICARE: DR. DENNIS COLLINS ROMARY 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	23028	CA

General Provider Information

NPI Number	:	1356347074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS COLLINS ROMARY DDS

Provider Business Mailing Address
First Line	:	328 MUIRFIELD CT
Second Line	:
City	:	CAMERON PARK
State	:	CA
Zip	:	95682-7665
Country	:	US
Telephone Number	:	530-672-9523
Fax Number	:	530-672-9523

Provider Business Practice Location Address
First Line	:	UNITED STATES NAVY RESERVE
Second Line	:
City	:	CAMERON PARK
State	:	CA
Zip	:	95682
Country	:	US
Telephone Number	:	530-672-9523
Fax Number	:	530-672-0952

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	06/11/2009

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