| Organization Name: | BAY STATE DENTAL & MEDICAL IMAGING INC. |
| NPI Number: | 1023103942 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BELA KASAS (PRESIDENT) |
| Mailing Address: | 1208b Vfw Pkwy Suite 301 West Roxbury |
| State: | MA US |
| Postal Code: | 021324349 |
| Phone Number: | 6173237050 |
| Fax Number: | 6179339722 |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | 04662 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |