Dr Damaris Bastian Gen.Dent. Llc in Fayetteville - Dentist
Dr Damaris Bastian Gen.Dent. Llc - NPI 1609089002
Dr Damaris Bastian Gen.Dent. Llc is a Dentist in Fayetteville, Georgia. Dr Damaris Bastian Gen.Dent. Llc practices all healthcare services and medical treatments related to Dentist. The NPI Number for Dr Damaris Bastian Gen.Dent. Llc is 1609089002. The last update date is 2021-11-08.
Dr Damaris Bastian Gen.Dent. Llc's current location address is 101 Devant St Ste 404, Fayetteville, Georgia. You can contact this provider via phone number 6788845352. The mailing address for Dr Damaris Bastian Gen.Dent. Llc is 101 Devant St Ste 404, Fayetteville, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Dr Damaris Bastian Gen.Dent. Llc |
|---|---|
| Address | 101 Devant St Ste 404, Fayetteville, Georgia |
| Phone Number | 6788845352 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Bastian Derece Damaris |
| Credentials | DDS |
| Telephone Number | 6788845352 |
NPI Number Detail
| NPI Number | 1609089002 |
|---|---|
| Provider Enumeration Date | 2007-05-08 |
| Last Updated Date | 2021-11-08 |
Provider Mailing Address Detail
| Address | 101 Devant St Ste 404 |
|---|---|
| City | Fayetteville |
| State | Georgia (GA) |
| Post Code | 302142713 |
| Phone Number | 6788845352 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 5087 |
|
Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1850870 | LA | -- | |
| 4334104830 | LA | BLUE CROSS BLUE SHEILD |
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What is the Dr Damaris Bastian Gen.Dent. Llc's unique identification number?
The Dr Damaris Bastian Gen.Dent. Llc has been assigned the NPI (National Provider Identifier) Number 1609089002 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the Dr Damaris Bastian Gen.Dent. Llc's physical address?
The Dr Damaris Bastian Gen.Dent. Llc is physically located at 101 Devant St Ste 404, in the city of Fayetteville, GA, with the postal code 302142713.
What is the Dr Damaris Bastian Gen.Dent. Llc's specialty and taxonomy code?
The Dr Damaris Bastian Gen.Dent. Llc's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
When was the Dr Damaris Bastian Gen.Dent. Llc's 1609089002 issued?
The Dr Damaris Bastian Gen.Dent. Llc's 1609089002 was issued on 2007-05-08.
As of what date was the information pertaining to Dr Damaris Bastian Gen.Dent. Llc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Dr Damaris Bastian Gen.Dent. Llc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2021-11-08.