MEDICARE: DR. SHERWIN ALAN KEVY 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	122300000X	Dentist	8584	MD

General Provider Information

NPI Number	:	1346274388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHERWIN ALAN KEVY D.D.S.

Provider Business Mailing Address
First Line	:	19221 MONTGOMERY VILLAGE AVE
Second Line	:	SUITE C-24
City	:	MONTGOMERY VILLAGE
State	:	MD
Zip	:	20886-5022
Country	:	US
Telephone Number	:	301-921-1021
Fax Number	:	301-990-0642

Provider Business Practice Location Address
First Line	:	19221 MONTGOMERY VILLAGE AVE
Second Line	:	SUITE C-24
City	:	MONTGOMERY VILLAGE
State	:	MD
Zip	:	20886-5022
Country	:	US
Telephone Number	:	301-921-1021
Fax Number	:	301-990-0642

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/08/2007

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