MEDICARE: DR. NANCY E CHAUVIN 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	1223G0001X	General Practice Dentistry	5133	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	91536	OTHER	NC	BLUE CROSS ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952477747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY E CHAUVIN DDS

Provider Business Mailing Address
First Line	:	816 LOWER DALLAS HWY
Second Line	:
City	:	DALLAS
State	:	NC
Zip	:	28034-9368
Country	:	US
Telephone Number	:	704-922-4147
Fax Number	:	704-922-9252

Provider Business Practice Location Address
First Line	:	816 LOWER DALLAS HWY
Second Line	:
City	:	DALLAS
State	:	NC
Zip	:	28034-9368
Country	:	US
Telephone Number	:	704-922-4147
Fax Number	:	704-922-9252

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

Provider Enumeration Date	:	11/26/2006
Last Update Date	:	07/08/2007

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