MEDICARE: DR. MARY MORAN DAY DDS

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	7154	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1808771	OTHER	NC	UNITED CONCORDIA/TRICARE
2	9025E	OTHER	NC	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1699740936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY MORAN DAY DDS

Provider Business Mailing Address
First Line	:	PO BOX 159
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-0159
Country	:	US
Telephone Number	:	252-222-3333
Fax Number	:	866-846-5876

Provider Business Practice Location Address
First Line	:	217 PROFESSIONAL CIR
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-4303
Country	:	US
Telephone Number	:	252-222-3333
Fax Number	:	866-846-5876

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/08/2007

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