| Bay State Oral Surgery Associates, Inc. | |
|
9 Linden Street Worcester MA 01609 | |
| (508) 755-0008 | |
| (508) 770-0603 |
| Full Name | Bay State Oral Surgery Associates, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 9 Linden Street, Worcester, Massachusetts |
| Authorized Official Name and Position | Xue Yu Shen (PRESIDENT) |
| Authorized Official Contact | 5087550008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay State Oral Surgery Associates, Inc. 9 Linden Street Worcester MA 01609 Ph: (508) 755-0008 | Bay State Oral Surgery Associates, Inc. 9 Linden Street Worcester MA 01609 Ph: (508) 755-0008 |
| NPI Number | 1679747398 |
|---|---|
| Provider Enumeration Date | 04/14/2008 |
| Last Update Date | 02/23/2009 |
| Medicare PECOS PAC ID | 1456485630 |
|---|---|
| Medicare Enrollment ID | O20100811000102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679747398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 21007 (Massachusetts) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 10436 (Massachusetts) | Secondary |
| Provider Name | Xue Yu Shen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1245249820 PECOS PAC ID: 4183615289 Enrollment ID: I20040519000073 |
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