MEDICARE: DR. ALAN KAZUMI KUWABARA D.D.S.

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	DEN1000054	DC

General Provider Information

NPI Number	:	1720120926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN KAZUMI KUWABARA D.D.S.

Provider Business Mailing Address
First Line	:	6709 SURREYWOOD LN
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-1550
Country	:	US
Telephone Number	:	301-469-4966
Fax Number	:

Provider Business Practice Location Address
First Line	:	5028 WISCONSIN AVE NW
Second Line	:	SUITE 200
City	:	WASHINGTON
State	:	DC
Zip	:	20016-4118
Country	:	US
Telephone Number	:	202-244-6111
Fax Number	:	202-244-6122

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/08/2007

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