MEDICARE: DR. BARUCH TWERSKY DMD

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	27849	CA

General Provider Information

NPI Number	:	1790884245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARUCH TWERSKY DMD

Provider Business Mailing Address
First Line	:	14401 BURBANK BLVD
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91401-4824
Country	:	US
Telephone Number	:	818-782-9500
Fax Number	:	818-782-0402

Provider Business Practice Location Address
First Line	:	14401 BURBANK BLVD
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91401-4824
Country	:	US
Telephone Number	:	818-782-9500
Fax Number	:	818-782-0402

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/08/2007

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