Provider Demographics
NPI:1114937729
Name:GAMSON, EDWARD KENNETH (DDS)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:KENNETH
Last Name:GAMSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 OLD GEORGETOWN RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1911
Mailing Address - Country:US
Mailing Address - Phone:301-493-4496
Mailing Address - Fax:301-493-4165
Practice Address - Street 1:10401 OLD GEORGETOWN RD
Practice Address - Street 2:SUITE 405
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1911
Practice Address - Country:US
Practice Address - Phone:301-493-4496
Practice Address - Fax:301-493-4165
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD93821223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics