Provider Demographics
NPI:1760648927
Name:BAJWA, HARVEEN (DDS)
Entity Type:Individual
Prefix:
First Name:HARVEEN
Middle Name:
Last Name:BAJWA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 PLEASANT ST # D
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7154
Mailing Address - Country:US
Mailing Address - Phone:978-258-3672
Mailing Address - Fax:
Practice Address - Street 1:234 PLEASANT ST # D
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-7154
Practice Address - Country:US
Practice Address - Phone:978-258-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice