MEDICARE: DR. TED VOSSERS 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	5537	NC

General Provider Information

NPI Number	:	1427104140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TED VOSSERS DDS

Provider Business Mailing Address
First Line	:	1616 MEMORIAL DR
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-3518
Country	:	US
Telephone Number	:	336-227-2733
Fax Number	:	336-227-9259

Provider Business Practice Location Address
First Line	:	1616 MEMORIAL DR
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-3518
Country	:	US
Telephone Number	:	336-227-2733
Fax Number	:	336-227-9259

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	07/08/2007

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