MEDICARE: DR. DANIEL A. DURAN 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	1657	NM

General Provider Information

NPI Number	:	1548263536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL A. DURAN D.D.S.

Provider Business Mailing Address
First Line	:	2974 N MAIN ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-1152
Country	:	US
Telephone Number	:	505-541-9366
Fax Number	:

Provider Business Practice Location Address
First Line	:	2974 N MAIN ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-1152
Country	:	US
Telephone Number	:	505-541-9366
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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