Provider Demographics
NPI:1265667794
Name:SCOTT T. BEDELL DDS,PC
Entity Type:Organization
Organization Name:SCOTT T. BEDELL DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:BEDELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-359-8004
Mailing Address - Street 1:2 W MILL ST
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-1507
Mailing Address - Country:US
Mailing Address - Phone:508-359-8004
Mailing Address - Fax:508-359-7443
Practice Address - Street 1:2 W MILL ST
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-1507
Practice Address - Country:US
Practice Address - Phone:508-359-8004
Practice Address - Fax:508-359-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty