MEDICARE: MS. MARGARET ANN PERRY RDH,

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	124Q00000X	Dental Hygienist	1333H	AZ

General Provider Information

NPI Number	:	1689848665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET ANN PERRY RDH,

Provider Business Mailing Address
First Line	:	3950 S COUNTRY CLUB RD
Second Line	:	SUITE 100, #1366F
City	:	TUCSON
State	:	AZ
Zip	:	85714-2099
Country	:	US
Telephone Number	:	520-243-7902
Fax Number	:	520-791-0366

Provider Business Practice Location Address
First Line	:	3950 S COUNTRY CLUB RD
Second Line	:	SUITE 100, #1366F
City	:	TUCSON
State	:	AZ
Zip	:	85714-2099
Country	:	US
Telephone Number	:	520-243-7902
Fax Number	:	520-791-0366

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

Provider Enumeration Date	:	04/21/2008
Last Update Date	:	04/21/2008

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