MEDICARE: DONALD MICHAEL ROMANO DMD

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	3276	AL

General Provider Information

NPI Number	:	1336219559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD MICHAEL ROMANO DMD

Provider Business Mailing Address
First Line	:	2038 PATTON CHAPEL ROAD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35216
Country	:	US
Telephone Number	:	205-822-7822
Fax Number	:	205-822-9452

Provider Business Practice Location Address
First Line	:	2038 PATTON CHAPEL ROAD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35216
Country	:	US
Telephone Number	:	205-822-7822
Fax Number	:	205-822-9452

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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