MEDICARE: DR. THOMAS MICHAEL BARANSKY 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DDS43418	CA

General Provider Information

NPI Number	:	1417926478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS MICHAEL BARANSKY DDS

Provider Business Mailing Address
First Line	:	4765 FRAZEE RD
Second Line	:	#1417
City	:	OCEANSIDE
State	:	CA
Zip	:	92057-6845
Country	:	US
Telephone Number	:	760-725-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	NAVAL HOSPITAL, CAMP PENDLETON
Second Line	:	BOX 555191 BLDG H100, ATTENTION: CODE 094
City	:	OCEANSIDE
State	:	CA
Zip	:	92055-5191
Country	:	US
Telephone Number	:	760-725-1200
Fax Number	:

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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