Provider Demographics
NPI:1720204886
Name:BEDI, KULWANT S (MS, DMD)
Entity Type:Individual
Prefix:DR
First Name:KULWANT
Middle Name:S
Last Name:BEDI
Suffix:
Gender:M
Credentials:MS, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6153 FORT KING RD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7520
Mailing Address - Country:US
Mailing Address - Phone:813-780-1403
Mailing Address - Fax:
Practice Address - Street 1:6153 FORT KING RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7520
Practice Address - Country:US
Practice Address - Phone:813-780-1403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 71661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice