MEDICARE: NORIN SIDDIQI 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	21237	OH

General Provider Information

NPI Number	:	1982816187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORIN SIDDIQI DDS

Provider Business Mailing Address
First Line	:	PO BOX 316
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14231
Country	:	US
Telephone Number	:	716-204-4999
Fax Number	:	716-632-2963

Provider Business Practice Location Address
First Line	:	4038 TALMADGE RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623
Country	:	US
Telephone Number	:	419-472-5838
Fax Number	:	419-472-5494

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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