MEDICARE: DR. PETER PERRY MICHAEL 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	DEN3569	DC

General Provider Information

NPI Number	:	1730286303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER PERRY MICHAEL D.D.S.

Provider Business Mailing Address
First Line	:	5100 CONNECTICUT AVE NW
Second Line	:	#201
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2002
Country	:	US
Telephone Number	:	202-363-1337
Fax Number	:	202-363-4205

Provider Business Practice Location Address
First Line	:	5100 CONNECTICUT AVE NW
Second Line	:	#201
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2002
Country	:	US
Telephone Number	:	202-363-1337
Fax Number	:	202-363-4205

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

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	10/27/2014

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