Bowen Zhou

Individual provider Active NPI General Practice Dentistry · Leicester, MA

NPI 1639737919 · NPPES record last updated Sep 4, 2020

Key facts

NPI
1639737919
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN1858615 (MA)
Practice address
119 S Main St
Leicester, MA 01524-1403
Phone
(508) 892-4882
NPI assigned
Jun 3, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN1858615MAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1858615 MA Yes

Addresses

Primary practice location

119 S Main St
Leicester, MA 01524-1403

Mailing address

319 E 95TH St Apt 24
New York, NY 10128-5742
Phone (508) 361-9154

Other providers in Leicester, MA

All providers in Leicester, MA · General Practice Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.