Provider Demographics
NPI:1619943479
Name:BEDELL, LAURENCE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:
Last Name:BEDELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 SMITH NECK RD
Mailing Address - Street 2:
Mailing Address - City:S DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748-1414
Mailing Address - Country:US
Mailing Address - Phone:508-993-3456
Mailing Address - Fax:508-785-0379
Practice Address - Street 1:307 SMITH NECK RD
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02748-1414
Practice Address - Country:US
Practice Address - Phone:508-993-3456
Practice Address - Fax:508-993-3456
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9140122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist