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NPI Code Detail

MEDICARE: BEDFORD DENTAL ARTS, LLC

MEDICARE: BEDFORD DENTAL ARTS, LLC
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
1122300000XDentistD18871MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
118871OTHERMALICENSE NUMBER

General Provider Information

NPI Number : 1548542681
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEDFORD DENTAL ARTS, LLC
Provider Business Mailing Address
First Line : 41 NORTH RD
Second Line : SUITE 207
City : BEDFORD
State : MA
Zip : 01730-1037
Country : US
Telephone Number : 781-275-2556
Fax Number : 781-275-2273
Provider Business Practice Location Address
First Line : 18 WESTFORD ST
Second Line :
City : CARLISLE
State : MA
Zip : 01741-1506
Country : US
Telephone Number : 978-369-7967
Fax Number : 781-275-2273
Authorized Official
Title or Position : MANAGER
Name : DR. WASSEEM AL ATTAR
Credential : DMD
Telephone Number : 781-258-5039
Provider Enumeration Date : 09/14/2011
Last Update Date : 01/22/2016

Similar Medicare Providers

1861483133 — DR. ANDREA RICHMAN DMD
Practice Location Address:
18 WESTFORD ST
CARLISLE, MA
01741-1506
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Practice Fax: 978-369-1086
1841247947 — TOWN OF CARLISLE
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1861865149 — DR. RUPA DAVE DDS
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1861054116 — DR. MEI-YEE CHAN DMD
Practice Location Address:
18 WESTFORD ST
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01741-1506
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Practice Fax:
1003588617 — DR. AHMED MOHAMED A. MOHAMED ABUGAD DMD
Practice Location Address:
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CARLISLE, MA
01741-1506
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Practice Fax:
1639169873 — MR. MARK A ROBART LICSW
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87 WOLF ROCK RD
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Directions to “BEDFORD DENTAL ARTS, LLC ” Practice Location

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