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Organization
NINA BASTI DDS, INC
Active
Organization
NINA BASTI DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NINOUSHA BASTI DDS (DENTIST)
(949) 492-0330
Entity
Organization
Contact information
Practice address
150 AVENIDA DEL MAR, STE C, SAN CLEMENTE, CA 92672-4010
(949) 492-0330
Mailing address
150 AVENIDA DEL MAR, STE C, SAN CLEMENTE, CA 92672-4010
(949) 492-0330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
55294
CA
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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