Provider Demographics
NPI:1093236622
Name:BHASKAR, HEMANT (DDS)
Entity Type:Individual
Prefix:
First Name:HEMANT
Middle Name:
Last Name:BHASKAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LOUISBURG SQ APT 6
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-6809
Mailing Address - Country:US
Mailing Address - Phone:906-361-6140
Mailing Address - Fax:
Practice Address - Street 1:26 WOOD ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-1519
Practice Address - Country:US
Practice Address - Phone:978-458-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857675122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist