MEDICARE: DR. STEPHEN M DARGAN D.D.S,P.A

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	6397	MD

General Provider Information

NPI Number	:	1538164900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN M DARGAN D.D.S,P.A

Provider Business Mailing Address
First Line	:	55 STOAKLEY RD
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-3859
Country	:	US
Telephone Number	:	410-535-4050
Fax Number	:	410-535-0932

Provider Business Practice Location Address
First Line	:	55 STOAKLEY RD
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-3859
Country	:	US
Telephone Number	:	410-535-4050
Fax Number	:	410-535-0932

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	11/03/2008

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