MEDICARE: BAY VIEW DENTAL

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	56480	CA

General Provider Information

NPI Number	:	1871735548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY VIEW DENTAL

Provider Business Mailing Address
First Line	:	2181 HARBOR BAY PKWY
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94502-3019
Country	:	US
Telephone Number	:	510-523-2188
Fax Number	:	510-523-2178

Provider Business Practice Location Address
First Line	:	2181 HARBOR BAY PKWY
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94502-3019
Country	:	US
Telephone Number	:	510-523-2188
Fax Number	:	510-523-2178

Authorized Official
Title or Position	:	CEO
Name	:	DR. PETER CHEN
Credential	:	D.D.S.
Telephone Number	:	510-523-2188

Provider Enumeration Date	:	03/27/2009
Last Update Date	:	03/27/2009

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Directions to “BAY VIEW DENTAL ” Practice Location

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