# REHAN BASHAR DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crescent Dental Bonney Lake
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801554084
- **Authorized official:** DR. SYED REHAN BASHAR DDS (OWNER/SOLE PROPRIETOR)
- **Authorized official phone:** (909) 556-3146

## Contact information

- **Practice address:** 10004 204TH AVE E STE 2500, BONNEY LAKE, WA 98391-6539
- **Practice address phone:** (253) 447-8344
- **Practice address fax:** (253) 447-8580
- **Mailing address:** 10004 204TH AVE E STE 2500, BONNEY LAKE, WA 98391-6539
- **Mailing address phone:** (253) 447-8344
- **Mailing address fax:** (253) 447-8580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/03/2021
- **Last updated:** 12/25/2021