MEDICARE: DR. JAIME J GARCIA DE PAREDES 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	038000-1	NY

General Provider Information

NPI Number	:	1609097047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAIME J GARCIA DE PAREDES D.D.S.

Provider Business Mailing Address
First Line	:	506 W GERMAN ST
Second Line	:
City	:	HERKIMER
State	:	NY
Zip	:	13350-1710
Country	:	US
Telephone Number	:	315-866-6871
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 S WASHINGTON ST
Second Line	:
City	:	HERKIMER
State	:	NY
Zip	:	13350-2426
Country	:	US
Telephone Number	:	315-866-2680
Fax Number	:

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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