Provider Demographics
NPI:1497813737
Name:KAM, VICTORIA BENGSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:BENGSON
Last Name:KAM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:BENGSON
Other - Last Name:OZAETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 1425
Mailing Address - Street 2:7 OAK HILL ROAD
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-4925
Mailing Address - Country:US
Mailing Address - Phone:978-692-8133
Mailing Address - Fax:978-692-8148
Practice Address - Street 1:7 OAK HILL ROAD
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-4925
Practice Address - Country:US
Practice Address - Phone:978-692-8133
Practice Address - Fax:978-692-8148
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA198881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice