Healthcare Provider Details

I. General information

NPI: 1154348910
Provider Name (Legal Business Name): CENTRAL NE CENTER FOR IMPLANT & COSMETIC DENTISRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 AUBURN ST
AUBURN MA
01501
US

IV. Provider business mailing address

176 AUBURN ST
AUBURN MA
01501
US

V. Phone/Fax

Practice location:
  • Phone: 508-832-5731
  • Fax: 508-832-0289
Mailing address:
  • Phone: 508-832-5731
  • Fax: 508-832-0289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18144
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number21056
License Number StateMA

VIII. Authorized Official

Name: ABHAYJIT S BEDI
Title or Position: PRESIDENT OWNER
Credential: DMD
Phone: 508-832-5731