MEDICARE: DR. LOUIS MICHAEL PAPADELIAS D.M.D.

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	DN10124	FL

General Provider Information

NPI Number	:	1548405210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS MICHAEL PAPADELIAS D.M.D.

Provider Business Mailing Address
First Line	:	12385 SORRENTO RD
Second Line	:	A-1
City	:	PENSACOLA
State	:	FL
Zip	:	32507-8664
Country	:	US
Telephone Number	:	850-492-0433
Fax Number	:	850-492-9655

Provider Business Practice Location Address
First Line	:	12385 SORRENTO RD
Second Line	:	A-1
City	:	PENSACOLA
State	:	FL
Zip	:	32507-8664
Country	:	US
Telephone Number	:	850-492-0433
Fax Number	:	850-492-9655

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

Provider Enumeration Date	:	12/10/2008
Last Update Date	:	12/10/2008

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