Provider Demographics
NPI:1619308020
Name:BAJWA DENTAL PC
Entity Type:Organization
Organization Name:BAJWA DENTAL PC
Other - Org Name:PLEASANT SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAJWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-421-6976
Mailing Address - Street 1:234 PLEASANT ST
Mailing Address - Street 2:234D
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7136
Mailing Address - Country:US
Mailing Address - Phone:978-258-3672
Mailing Address - Fax:978-655-3057
Practice Address - Street 1:234 PLEASANT ST
Practice Address - Street 2:234D
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-7136
Practice Address - Country:US
Practice Address - Phone:978-258-3672
Practice Address - Fax:978-655-3057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty