MEDICARE: DR. MICHAEL JAMES DAILEY 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 | 48591 | CA |
| NPI Number |
: |
1306838917 |
| Entity Type Code |
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Individual |
| Provider Name (Legal Business Name) |
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DR. MICHAEL JAMES DAILEY D.D.S.
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| Provider Business Mailing Address |
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| First Line |
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UNIT 3865
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Second Line
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City
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APO
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State
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AE
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Zip
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09126
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Country
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DE
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Telephone Number
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4-965-6169
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Fax Number
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3183
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Provider Business Practice Location Address
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First Line
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UNIT 3865
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Second Line
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City
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APO
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State
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AE
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Zip
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09126
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Country
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DE
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Telephone Number
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4-965-6169
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Fax Number
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3183
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Authorized Official
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Title or Position
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Name
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Credential
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Telephone Number
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Provider Enumeration Date
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08/19/2005
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Last Update Date
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07/08/2007
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