Healthcare Provider Details

I. General information

NPI: 1154368652
Provider Name (Legal Business Name): BARBARA A LESCO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 EAST LEE STREET
BALTIMORE MD
21202-6013
US

IV. Provider business mailing address

2 EAST LEE STREET
BALTIMORE MD
21202-6013
US

V. Phone/Fax

Practice location:
  • Phone: 410-727-6190
  • Fax: 410-659-0839
Mailing address:
  • Phone: 410-727-6190
  • Fax: 410-659-0839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number6422
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: