MEDICARE: DAVID LEE EURICH 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	17559	TX
2	1223G0001X	General Practice Dentistry	26385	CA
3	1223G0001X	General Practice Dentistry	7913	CO

General Provider Information

NPI Number	:	1376671578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID LEE EURICH DDS

Provider Business Mailing Address
First Line	:	PO BOX 675
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76241-0675
Country	:	US
Telephone Number	:	940-665-0726
Fax Number	:	940-665-0618

Provider Business Practice Location Address
First Line	:	301 E CALIFORNIA ST
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-4005
Country	:	US
Telephone Number	:	940-665-0726
Fax Number	:	940-665-0618

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/08/2007

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