MEDICARE: DR. JOHN LEWIS SINGLETON 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	1223G0001X	General Practice Dentistry		WV

General Provider Information

NPI Number	:	1033246657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN LEWIS SINGLETON DDS

Provider Business Mailing Address
First Line	:	1315 2ND ST SW
Second Line	:	SUITE 100
City	:	ROANOKE
State	:	VA
Zip	:	24016-4935
Country	:	US
Telephone Number	:	540-343-5521
Fax Number	:	540-343-0923

Provider Business Practice Location Address
First Line	:	1315 2ND ST SW
Second Line	:	SUITE 100
City	:	ROANOKE
State	:	VA
Zip	:	24016-4935
Country	:	US
Telephone Number	:	540-343-5521
Fax Number	:	540-343-0923

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/08/2007

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