MEDICARE: DR. GARY MICHAEL CUMMINGS 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	1223G0001X	General Practice Dentistry	0401006839	VA

General Provider Information

NPI Number	:	1568463024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY MICHAEL CUMMINGS D.M.D.

Provider Business Mailing Address
First Line	:	101 WENTWORTH
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-9187
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	USS CARL VINSON CVN-70
Second Line	:	DENTAL DEPARTMENT
City	:	FPO AE
State	:	VA
Zip	:	09566
Country	:	US
Telephone Number	:	757-817-2880
Fax Number	:

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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