Provider Demographics
NPI:1417043308
Name:BHAN, HARPAL KAUR (DMD)
Entity Type:Individual
Prefix:
First Name:HARPAL
Middle Name:KAUR
Last Name:BHAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 W ROXBURY PKWY
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3702
Mailing Address - Country:US
Mailing Address - Phone:617-469-8244
Mailing Address - Fax:617-327-5050
Practice Address - Street 1:540 VFW PKWY STE 5
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-1332
Practice Address - Country:US
Practice Address - Phone:617-327-5700
Practice Address - Fax:617-327-5050
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA185291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice