MEDICARE: DR. STEVEN EDMUND LEDWIG 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	1223G0001X	General Practice Dentistry	20297	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710025598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN EDMUND LEDWIG D.D.S.

Provider Business Mailing Address
First Line	:	1583 THOUSAND OAKS DR
Second Line	:	SUITE # 117
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-2300
Country	:	US
Telephone Number	:	210-495-5023
Fax Number	:	210-490-0354

Provider Business Practice Location Address
First Line	:	1583 THOUSAND OAKS DR
Second Line	:	SUITE # 117
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-2300
Country	:	US
Telephone Number	:	210-495-5023
Fax Number	:	210-490-0354

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	02/25/2015

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Directions to “ DR. STEVEN EDMUND LEDWIG D.D.S.” Practice Location

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