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General NPI Number Information
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NPI Number | 1962767830
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Entity Type | Individual
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Provider Name | DR. REBECCA PERSCHON
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Gender | Female
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Dates
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Enumeration Date | 07/06/2012
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Last Update Date | 07/06/2012
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Provider Practice Location Address
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Address Line | 8757 GEORGIA AVE SUITE 530
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City | SILVER SPRING
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State | MD
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Zip | 20910-3737
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Country | US
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Telephone | 301-587-6696
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Fax |
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Provider Business Mailing Address
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Address Line | 8757 GEORGIA AVE STE 530
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City | SILVER SPRING
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State | MD
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Zip | 20910-3759
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Country | US
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Telephone | 301-587-6696
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14957
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License Number State | MD
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