Provider Demographics
NPI:1699783662
Name:HARPAL BHAN DMD & PARDAMAN BHAN DMD PC
Entity type:Organization
Organization Name:HARPAL BHAN DMD & PARDAMAN BHAN DMD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PARDAMAN
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-327-5700
Mailing Address - Street 1:540 VFW PARKWAY
Mailing Address - Street 2:STE 5 WESTBROOK FAMILY DENTAL CARE
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132
Mailing Address - Country:US
Mailing Address - Phone:617-327-5700
Mailing Address - Fax:617-327-5050
Practice Address - Street 1:540 VFW PARKWAY
Practice Address - Street 2:STE 5 WESTBROOK FAMILY DENTAL CARE
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132
Practice Address - Country:US
Practice Address - Phone:617-327-5700
Practice Address - Fax:617-327-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA18530122300000X
MAMA18529122300000X
MAMA14460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty