MEDICARE: SEMTNER & SEMTNER, DDS, INC.

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	0401410235	VA
2	1223G0001X	General Practice Dentistry	0401410195	VA

General Provider Information

NPI Number	:	1417007295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEMTNER & SEMTNER, DDS, INC.

Provider Business Mailing Address
First Line	:	4370 STARKEY RD STE 1B
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-0603
Country	:	US
Telephone Number	:	540-989-0112
Fax Number	:	540-989-0049

Provider Business Practice Location Address
First Line	:	4370 STARKEY RD STE 1B
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-0603
Country	:	US
Telephone Number	:	540-989-0112
Fax Number	:	540-989-0049

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT B SEMTNER
Credential	:	DDS
Telephone Number	:	540-989-0112

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	05/04/2010

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