MEDICARE: DR. DARIO A FENIMORE 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	22DI01093600	NJ

General Provider Information

NPI Number	:	1013981281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARIO A FENIMORE D.M.D.

Provider Business Mailing Address
First Line	:	14 TOWER HILL RD
Second Line	:
City	:	MORRIS PLAINS
State	:	NJ
Zip	:	07950-2020
Country	:	US
Telephone Number	:	973-539-7048
Fax Number	:	973-538-9336

Provider Business Practice Location Address
First Line	:	442 SPEEDWELL AVE
Second Line	:
City	:	MORRIS PLAINS
State	:	NJ
Zip	:	07950-2133
Country	:	US
Telephone Number	:	873-538-2238
Fax Number	:	973-538-9336

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	07/08/2007

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