MEDICARE: DR. GERALD GINSBERG DDS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS015109L	PA

General Provider Information

NPI Number	:	1700914256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD GINSBERG DDS

Provider Business Mailing Address
First Line	:	1288 VALLEY FORGE RD
Second Line	:	SUITE 60
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-2687
Country	:	US
Telephone Number	:	610-935-1547
Fax Number	:	610-935-7630

Provider Business Practice Location Address
First Line	:	1288 VALLEY FORGE RD
Second Line	:	SUITE 60
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-2687
Country	:	US
Telephone Number	:	610-935-1547
Fax Number	:	610-935-7630

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/08/2007

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