MEDICARE: DR. EDWARD LEE GINSBERG 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	1223P0221X	Pediatric Dentistry	7886	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7886	OTHER	MD	STATE DENTAL LICENSE

General Provider Information

NPI Number	:	1053534743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD LEE GINSBERG DDS

Provider Business Mailing Address
First Line	:	15 DIAMOND CREST CT
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-1500
Country	:	US
Telephone Number	:	410-653-3080
Fax Number	:

Provider Business Practice Location Address
First Line	:	1134 N ROLLING RD
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-3826
Country	:	US
Telephone Number	:	410-788-4555
Fax Number	:

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	07/08/2007

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