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General NPI Number Information
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NPI Number | 1750651766
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Entity Type | Organization
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Legal Business Name | BERNARD L. GREENBAUM, DDS, PC
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 6410 ROCKLEDGE DR 106
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City | BETHESDA
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State | MD
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Zip | 20817-1809
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Country | US
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Telephone | 310-530-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 6410 ROCKLEDGE DR 106
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City | BETHESDA
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State | MD
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Zip | 20817-1809
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Country | US
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Telephone | 310-530-3600
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | BERNARD GREENBAUM
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Credential | DDS
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Telephone | 301-530-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 7748
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License Number State | MD
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