MEDICARE: DR. NATHAN LOUIS FLETCHER 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	1223G0001X	General Practice Dentistry	9899	MD

General Provider Information

NPI Number	:	1487643797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN LOUIS FLETCHER D.D.S.

Provider Business Mailing Address
First Line	:	8250 STREAMWOOD DR
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-2135
Country	:	US
Telephone Number	:	410-298-2700
Fax Number	:	410-298-7299

Provider Business Practice Location Address
First Line	:	3320 SAINT LUKES LN
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-5704
Country	:	US
Telephone Number	:	410-298-2700
Fax Number	:	410-298-7299

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	07/09/2007

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