MEDICARE: DR. JAMIE MICHELE DAY DDS,MS

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	1223E0200X	Endodontics	WV3641	WV

General Provider Information

NPI Number	:	1568648905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE MICHELE DAY DDS,MS

Provider Business Mailing Address
First Line	:	106 CAMBRIDGE PL
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-2812
Country	:	US
Telephone Number	:	304-842-6333
Fax Number	:	304-842-8558

Provider Business Practice Location Address
First Line	:	106 CAMBRIDGE PL
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-2812
Country	:	US
Telephone Number	:	304-842-6333
Fax Number	:	304-842-8558

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

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	01/16/2008

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