MEDICARE: DR. ROBERT CHARLES NAZAR D.M.D

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	1223G0001X	General Practice Dentistry	10179	MA

General Provider Information

NPI Number	:	1548294754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT CHARLES NAZAR D.M.D

Provider Business Mailing Address
First Line	:	190 MOUNT AUBURN ST
Second Line	:	A-2
City	:	WATERTOWN
State	:	MA
Zip	:	02472-4046
Country	:	US
Telephone Number	:	617-923-0233
Fax Number	:	617-923-8750

Provider Business Practice Location Address
First Line	:	190 MOUNT AUBURN ST
Second Line	:	A-2
City	:	WATERTOWN
State	:	MA
Zip	:	02472-4046
Country	:	US
Telephone Number	:	617-923-0233
Fax Number	:	617-923-8750

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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