MEDICARE: DOUGLAS TOPPER 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	122300000X	Dentist	31720	CA

General Provider Information

NPI Number	:	1760596878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS TOPPER DDS

Provider Business Mailing Address
First Line	:	530 LOS ANGELES AVE
Second Line	:	#213
City	:	MOORPARK
State	:	CA
Zip	:	93021-2089
Country	:	US
Telephone Number	:	805-523-0110
Fax Number	:	805-523-8340

Provider Business Practice Location Address
First Line	:	530 LOS ANGELES AVE
Second Line	:	#213
City	:	MOORPARK
State	:	CA
Zip	:	93021-2089
Country	:	US
Telephone Number	:	805-523-0110
Fax Number	:	805-523-8340

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	07/08/2007

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Directions to “ DOUGLAS TOPPER DDS” Practice Location

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