Provider Demographics
NPI:1770894156
Name:WILLIAM R BEBRIN, DMD, PC
Entity type:Organization
Organization Name:WILLIAM R BEBRIN, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIGREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-777-1300
Mailing Address - Street 1:119 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01949-3303
Mailing Address - Country:US
Mailing Address - Phone:978-777-1300
Mailing Address - Fax:
Practice Address - Street 1:119 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-3303
Practice Address - Country:US
Practice Address - Phone:978-777-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN02540251B00000X
MA17481251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1841405479OtherNPI TYPE 1