MEDICARE: DR. MICHAEL STEVEN AYES 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	122300000X	Dentist	DS 0190980L	PA

General Provider Information

NPI Number	:	1467597351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL STEVEN AYES D.D.S.

Provider Business Mailing Address
First Line	:	16 LLANBERRIS RD
Second Line	:
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-2403
Country	:	US
Telephone Number	:	484-234-5130
Fax Number	:	484-234-5138

Provider Business Practice Location Address
First Line	:	722 MARKET ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-2312
Country	:	US
Telephone Number	:	484-234-5130
Fax Number	:	484-234-5138

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/08/2007

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