MEDICARE: DR. JESSICA ARMSTRONG 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	3998	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376638551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA ARMSTRONG DMD

Provider Business Mailing Address
First Line	:	3425 HIGHWAY 153
Second Line	:
City	:	PIEDMONT
State	:	SC
Zip	:	29673-7725
Country	:	US
Telephone Number	:	864-295-8678
Fax Number	:	864-752-1221

Provider Business Practice Location Address
First Line	:	3425 HIGHWAY 153
Second Line	:
City	:	PIEDMONT
State	:	SC
Zip	:	29673-7725
Country	:	US
Telephone Number	:	864-295-8678
Fax Number	:	864-752-1221

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/09/2007

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