Provider Demographics
NPI:1104111343
Name:BZD DENTAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:BZD DENTAL ASSOCIATES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BADRI
Authorized Official - Middle Name:Z
Authorized Official - Last Name:DEBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-533-8378
Mailing Address - Street 1:610 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-3638
Mailing Address - Country:US
Mailing Address - Phone:413-533-8378
Mailing Address - Fax:413-534-3989
Practice Address - Street 1:610 SOUTH ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-3638
Practice Address - Country:US
Practice Address - Phone:413-533-8378
Practice Address - Fax:413-534-3989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN185761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty