MEDICARE: DR. EDWARD ZEBOVITZ 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	11033	MD

General Provider Information

NPI Number	:	1801935572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD ZEBOVITZ D.D.S.

Provider Business Mailing Address
First Line	:	4311 NORTHVIEW DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2600
Country	:	US
Telephone Number	:	301-352-6311
Fax Number	:	301-352-0146

Provider Business Practice Location Address
First Line	:	4311 NORTHVIEW DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2600
Country	:	US
Telephone Number	:	301-352-6311
Fax Number	:	301-352-0146

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	07/08/2007

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