MEDICARE: DR. DENNIS N MCAFEE D.D.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	10893	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	454177	OTHER		UNITED CONCORDIA INSURANC

General Provider Information

NPI Number	:	1497869721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS N MCAFEE D.D.S.

Provider Business Mailing Address
First Line	:	2904 N 4TH ST
Second Line	:	SUITE 106
City	:	LONGVIEW
State	:	TX
Zip	:	75605-5129
Country	:	US
Telephone Number	:	903-758-3700
Fax Number	:	903-234-8658

Provider Business Practice Location Address
First Line	:	2904 N 4TH ST
Second Line	:	SUITE 106
City	:	LONGVIEW
State	:	TX
Zip	:	75605-5129
Country	:	US
Telephone Number	:	903-758-3700
Fax Number	:	903-234-8658

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/09/2007

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