MEDICARE: MARY MORAN DAY, DDS, PA

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	122300000X	Dentist	7154	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1808771	OTHER		TRICARE
2	9025E	OTHER	NC	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1881637684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY MORAN DAY, DDS, PA

Provider Business Mailing Address
First Line	:	217 PROFESSIONAL CIR
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-4303
Country	:	US
Telephone Number	:	252-222-3333
Fax Number	:	866-846-5876

Provider Business Practice Location Address
First Line	:	217 PROFESSIONAL CIR
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-4303
Country	:	US
Telephone Number	:	252-222-3333
Fax Number	:	866-846-5876

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARY MORAN DAY
Credential	:	DDS
Telephone Number	:	252-222-3333

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	08/22/2020

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