Provider Demographics
NPI:1376665000
Name:BEDFORD DENTAL CARE
Entity Type:Organization
Organization Name:BEDFORD DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:RICHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-625-2193
Mailing Address - Street 1:207 MEETINGHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6090
Mailing Address - Country:US
Mailing Address - Phone:603-625-2193
Mailing Address - Fax:603-669-9100
Practice Address - Street 1:207 MEETINGHOUSE RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6090
Practice Address - Country:US
Practice Address - Phone:603-625-2193
Practice Address - Fax:603-669-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty