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NPI Code Detail

MEDICARE: DR. AUGUST METZ IV D.M.D.

MEDICARE: DR. AUGUST METZ IV D.M.D.
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
11223G0001XGeneral Practice Dentistry7817OK

General Provider Information

NPI Number : 1992930523
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AUGUST METZ IV D.M.D.
Provider Business Mailing Address
First Line : 3323 WIEHLE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19129-1751
Country : US
Telephone Number : 570-604-6598
Fax Number :
Provider Business Practice Location Address
First Line : 1829 S WOOD DR
Second Line :
City : OKMULGEE
State : OK
Zip : 74447-6825
Country : US
Telephone Number : 918-756-6500
Fax Number : 918-756-6505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2009
Last Update Date : 03/20/2024

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