MEDICARE: DR. RONALD LEWITT DAYMON D.D.S., M.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	046598	NY

General Provider Information

NPI Number	:	1073643243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD LEWITT DAYMON D.D.S., M.S.

Provider Business Mailing Address
First Line	:	1295 PORTLAND AVE
Second Line	:	SUITE 21
City	:	ROCHESTER
State	:	NY
Zip	:	14621-2731
Country	:	US
Telephone Number	:	585-342-8050
Fax Number	:	585-342-9024

Provider Business Practice Location Address
First Line	:	1295 PORTLAND AVE
Second Line	:	SUITE 21
City	:	ROCHESTER
State	:	NY
Zip	:	14621-2731
Country	:	US
Telephone Number	:	585-342-8050
Fax Number	:	585-342-9024

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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