MEDICARE: JOHN E. CONTI D.D.S.

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	24757	CA

General Provider Information

NPI Number	:	1033236815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN E. CONTI D.D.S.

Provider Business Mailing Address
First Line	:	5565 CARPINTERIA AVE
Second Line	:	SUITE 21
City	:	CARPINTERIA
State	:	CA
Zip	:	93013-1446
Country	:	US
Telephone Number	:	805-684-5454
Fax Number	:	805-566-1854

Provider Business Practice Location Address
First Line	:	5565 CARPINTERIA AVE
Second Line	:	SUITE 21
City	:	CARPINTERIA
State	:	CA
Zip	:	93013-1446
Country	:	US
Telephone Number	:	805-684-5454
Fax Number	:	805-566-1854

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

Provider Enumeration Date	:	03/25/2007
Last Update Date	:	07/08/2007

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