MEDICARE: DR. ARTHUR F DOUGLASS JR. 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DS022591L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386601300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR F DOUGLASS JR. D.D.S.

Provider Business Mailing Address
First Line	:	6 HEARTHSTONE CT
Second Line	:	SUITE 301
City	:	READING
State	:	PA
Zip	:	19606-3065
Country	:	US
Telephone Number	:	610-370-2300
Fax Number	:	610-370-2303

Provider Business Practice Location Address
First Line	:	6 HEARTHSTONE CT
Second Line	:	SUITE 301
City	:	READING
State	:	PA
Zip	:	19606-3065
Country	:	US
Telephone Number	:	610-370-2300
Fax Number	:	610-370-2303

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	07/08/2007

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