MEDICARE: IOANA GABRIELA DEMETER 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	27306	TX
2	1223G0001X	General Practice Dentistry	DS038859	PA

General Provider Information

NPI Number	:	1306126610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IOANA GABRIELA DEMETER DDS

Provider Business Mailing Address
First Line	:	2804 ISLAND WREN DR
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75181-4938
Country	:	US
Telephone Number	:	954-600-8846
Fax Number	:

Provider Business Practice Location Address
First Line	:	9201 ELAM RD
Second Line	:	STE 101
City	:	DALLAS
State	:	TX
Zip	:	75217-4152
Country	:	US
Telephone Number	:	214-266-1618
Fax Number	:

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

Provider Enumeration Date	:	08/18/2011
Last Update Date	:	08/18/2011

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