MEDICARE: DR. DANIEL G ARREDONDO 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	742129354	TX

General Provider Information

NPI Number	:	1417125816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL G ARREDONDO DDS

Provider Business Mailing Address
First Line	:	3740 COLONY DR
Second Line	:	SUITE 254
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2234
Country	:	US
Telephone Number	:	210-690-5170
Fax Number	:	210-690-8522

Provider Business Practice Location Address
First Line	:	3740 COLONY DR
Second Line	:	SUITE 254
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2234
Country	:	US
Telephone Number	:	210-690-5170
Fax Number	:	210-690-8522

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

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	02/19/2008

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