Healthcare Provider Details

I. General information

NPI: 1124157086
Provider Name (Legal Business Name): BEDFORD DENTAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 LOOMIS ST
BEDFORD MA
01730-2208
US

IV. Provider business mailing address

50 LOOMIS ST
BEDFORD MA
01730-2208
US

V. Phone/Fax

Practice location:
  • Phone: 781-275-7072
  • Fax: 781-275-9118
Mailing address:
  • Phone: 781-275-7072
  • Fax: 781-275-9118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL S GARBER
Title or Position: DENTIST OWNER
Credential: D.M.D
Phone: 781-275-7072