MEDICARE: DR. SENHARIP TANOGLU DMD

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	17386	MA

General Provider Information

NPI Number	:	1548355746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SENHARIP TANOGLU DMD

Provider Business Mailing Address
First Line	:	101 PLEASANT STREET
Second Line	:	SUITE 208
City	:	WORCESTER
State	:	MA
Zip	:	01609-3213
Country	:	US
Telephone Number	:	508-770-0808
Fax Number	:	508-754-3145

Provider Business Practice Location Address
First Line	:	101 PLEASANT STREET
Second Line	:	SUITE 208
City	:	WORCESTER
State	:	MA
Zip	:	01609-3213
Country	:	US
Telephone Number	:	508-770-0808
Fax Number	:	508-754-3145

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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