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NPI Code Detail

MEDICARE: DR. PETER S TRAGER DDS

MEDICARE: DR. PETER S TRAGER 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
11223G0001XGeneral Practice Dentistry7814GA

Other Identifiers

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

General Provider Information

NPI Number : 1386647139
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER S TRAGER DDS
Provider Business Mailing Address
First Line : 2480 WINDY HILL RD SE
Second Line : STE 405
City : MARIETTA
State : GA
Zip : 30067-8658
Country : US
Telephone Number : 770-952-0136
Fax Number : 770-952-0137
Provider Business Practice Location Address
First Line : 2480 WINDY HILL RD SE
Second Line : STE 405
City : MARIETTA
State : GA
Zip : 30067-8658
Country : US
Telephone Number : 770-952-0136
Fax Number : 770-952-0137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 03/30/2009

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Directions to “ DR. PETER S TRAGER DDS” Practice Location

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