MEDICARE: DR. MICHAEL SIGNORELLI SIGNORELLI DDS, MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	3033	WV

General Provider Information

NPI Number	:	1871585463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL SIGNORELLI SIGNORELLI DDS, MS

Provider Business Mailing Address
First Line	:	UNIT 3865
Second Line	:
City	:	APO
State	:	AE
Zip	:	09126
Country	:	DE
Telephone Number	:	4-965-6169
Fax Number	:	3593

Provider Business Practice Location Address
First Line	:	UNIT 3865
Second Line	:
City	:	APO
State	:	AE
Zip	:	09126
Country	:	DE
Telephone Number	:	4-965-6169
Fax Number	:	3593

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	07/08/2007

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