Provider Demographics
NPI:1154348910
Name:CENTRAL NE CENTER FOR IMPLANT & COSMETIC DENTISRY PC
Entity type:Organization
Organization Name:CENTRAL NE CENTER FOR IMPLANT & COSMETIC DENTISRY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABHAYJIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEDI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-832-5731
Mailing Address - Street 1:176 AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501
Mailing Address - Country:US
Mailing Address - Phone:508-832-5731
Mailing Address - Fax:508-832-0289
Practice Address - Street 1:176 AUBURN ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501
Practice Address - Country:US
Practice Address - Phone:508-832-5731
Practice Address - Fax:508-832-0289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA181441223G0001X
MA210561223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty