MEDICARE: DR. ROBERT BAARSVIK 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	17055	MA

General Provider Information

NPI Number	:	1184775314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT BAARSVIK D.D.S.

Provider Business Mailing Address
First Line	:	1403 TUCKER RD
Second Line	:
City	:	NORTH DARTMOUTH
State	:	MA
Zip	:	02747-3152
Country	:	US
Telephone Number	:	508-990-1499
Fax Number	:	508-990-8899

Provider Business Practice Location Address
First Line	:	1403 TUCKER RD
Second Line	:
City	:	NORTH DARTMOUTH
State	:	MA
Zip	:	02747-3152
Country	:	US
Telephone Number	:	508-990-1499
Fax Number	:	508-990-8899

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	07/08/2007

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