MEDICARE: DR. MICHAEL H. DAVIES DMD

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	122300000X	Dentist	19335	MA

General Provider Information

NPI Number	:	1740309046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL H. DAVIES DMD

Provider Business Mailing Address
First Line	:	24 WALL ST
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-4836
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 N MAIN ST
Second Line	:	SUITE 203
City	:	NATICK
State	:	MA
Zip	:	01760-1100
Country	:	US
Telephone Number	:	508-655-5331
Fax Number	:	508-655-5449

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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