MEDICARE: DR. GARY M SILBERNAGEL D.M.D.

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	3195	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	92657	OTHER	AL	BCBS IDENTIFICATION
2	846692	OTHER	AL	UNITED CONCORDIA PROVIDER

General Provider Information

NPI Number	:	1679595839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY M SILBERNAGEL D.M.D.

Provider Business Mailing Address
First Line	:	PO BOX 919
Second Line	:
City	:	FLOMATON
State	:	AL
Zip	:	36441-0919
Country	:	US
Telephone Number	:	251-296-2486
Fax Number	:

Provider Business Practice Location Address
First Line	:	2124 RINGOLD ST
Second Line	:
City	:	FLOMATON
State	:	AL
Zip	:	36441
Country	:	US
Telephone Number	:	251-296-2486
Fax Number	:

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/09/2007

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