MEDICARE: VASANT K KAMATH DMD

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	D14924	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598879215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VASANT K KAMATH DMD

Provider Business Mailing Address
First Line	:	1141 PLEASANT STREET
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02723
Country	:	US
Telephone Number	:	508-674-5583
Fax Number	:	508-674-5647

Provider Business Practice Location Address
First Line	:	1141 PLEASANT STREET
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02723
Country	:	US
Telephone Number	:	508-674-5583
Fax Number	:	508-674-5647

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	07/08/2007

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