Provider Demographics
NPI:1235210337
Name:ZYOUD, BASHAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:BASHAR
Middle Name:
Last Name:ZYOUD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 GATES ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5503
Mailing Address - Country:US
Mailing Address - Phone:617-312-9177
Mailing Address - Fax:
Practice Address - Street 1:347 GREENWOOD STREET
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01607
Practice Address - Country:US
Practice Address - Phone:508-790-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20357122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist