MEDICARE: ROY LIONEL ESKOW 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	1223P0300X	Periodontics	5640	MD

General Provider Information

NPI Number	:	1861583122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROY LIONEL ESKOW D.D.S.

Provider Business Mailing Address
First Line	:	5626 SHIELDS DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-3532
Country	:	US
Telephone Number	:	301-493-6200
Fax Number	:	301-564-4358

Provider Business Practice Location Address
First Line	:	5626 SHIELDS DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-3532
Country	:	US
Telephone Number	:	301-493-6200
Fax Number	:	301-564-4358

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/08/2007

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