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Organization
DAVID C BASTACKY DMD PA
Active
Organization
DAVID C BASTACKY DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BASTACKY DMD PA (DOCTOR OWNER)
(410) 744-4222
Entity
Organization
Contact information
Practice address
516 N ROLLING RD, SUITE 104, BALTIMORE, MD 21228-4140
(410) 744-4222
(410) 744-2472
Mailing address
516 N ROLLING RD, SUITE 104, BALTIMORE, MD 21228-4140
(410) 744-4222
(410) 744-2472
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10337
MD
Other
Enumeration date
03/20/2007
Last updated
04/20/2008
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