MEDICARE: DR. DANON GARRISON 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	36367	CA

General Provider Information

NPI Number	:	1558465773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANON GARRISON D.D.S.

Provider Business Mailing Address
First Line	:	6035 BRISTOL PKWY
Second Line	:	SUITE #200
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6601
Country	:	US
Telephone Number	:	800-373-5400
Fax Number	:	888-492-2900

Provider Business Practice Location Address
First Line	:	6035 BRISTOL PKWY
Second Line	:	SUITE#200
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6601
Country	:	US
Telephone Number	:	800-373-5400
Fax Number	:	888-492-2900

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

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

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