Healthcare Provider Details

I. General information

NPI: 1376665000
Provider Name (Legal Business Name): BEDFORD DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 MEETINGHOUSE RD
BEDFORD NH
03110-6090
US

IV. Provider business mailing address

207 MEETINGHOUSE RD
BEDFORD NH
03110-6090
US

V. Phone/Fax

Practice location:
  • Phone: 603-625-2193
  • Fax: 603-669-9100
Mailing address:
  • Phone: 603-625-2193
  • Fax: 603-669-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM F RICHEY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 603-625-2193