MEDICARE: DR. ORIN JAY OBERLANDER 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	122300000X	Dentist	15056	FL

General Provider Information

NPI Number	:	1033279641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ORIN JAY OBERLANDER D.D.S.

Provider Business Mailing Address
First Line	:	30470 BETTS RD
Second Line	:
City	:	MYAKKA CITY
State	:	FL
Zip	:	34251-9596
Country	:	US
Telephone Number	:	941-322-1280
Fax Number	:

Provider Business Practice Location Address
First Line	:	30470 BETTS RD
Second Line	:
City	:	MYAKKA CITY
State	:	FL
Zip	:	34251-9596
Country	:	US
Telephone Number	:	941-322-1280
Fax Number	:

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	05/18/2012

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