MEDICARE: DR. BAMIDELE J APAPA DDS

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	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	30-020888	OH

General Provider Information

NPI Number	:	1831188879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BAMIDELE J APAPA DDS

Provider Business Mailing Address
First Line	:	3550 FAR HILLS AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45429-2502
Country	:	US
Telephone Number	:	937-298-5239
Fax Number	:	937-298-5068

Provider Business Practice Location Address
First Line	:	3550 FAR HILLS AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45429-2502
Country	:	US
Telephone Number	:	937-298-5239
Fax Number	:	937-298-5068

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/08/2007

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