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Organization
C. LEE BASS, III, DDS, PA
Active
Organization
C. LEE BASS, III, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL LEE BASS III DDS (PRESIDENT/DENTIST)
(704) 873-3321
Entity
Organization
Contact information
Practice address
646 SIGNAL HILL DRIVE EXT, STATESVILLE, NC 28625-4353
(704) 873-3321
Mailing address
646 SIGNAL HILL DRIVE EXT, STATESVILLE, NC 28625-4353
(704) 873-3321
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6420
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
467563
UNITED CONCORDIA
NC
01
—
90511
BCBSNC
NC
Enumeration date
09/06/2006
Last updated
08/22/2020
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