MEDICARE: DR. PEARSTINE ADGERSON 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	13410	MD

General Provider Information

NPI Number	:	1528081825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEARSTINE ADGERSON DDS

Provider Business Mailing Address
First Line	:	3611 BRANCH AVE
Second Line	:	SUITE #301
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-1242
Country	:	US
Telephone Number	:	301-702-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3611 BRANCH AVE
Second Line	:	SUITE #301
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-1242
Country	:	US
Telephone Number	:	301-702-2700
Fax Number	:

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	10/21/2008

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