MEDICARE: DR. DEMETRIOS P MILONAS 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		VA

General Provider Information

NPI Number	:	1811055395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEMETRIOS P MILONAS DDS

Provider Business Mailing Address
First Line	:	2865 LYNNHAVEN DR
Second Line	:	SUITE C-4
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1542
Country	:	US
Telephone Number	:	757-481-3000
Fax Number	:	757-481-3551

Provider Business Practice Location Address
First Line	:	2865 LYNNHAVEN DR
Second Line	:	SUITE C-4
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1542
Country	:	US
Telephone Number	:	757-481-3000
Fax Number	:	757-481-3551

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/08/2007

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