Organization
A.T. BASSIRI, D.D.S., P.A.
Active
Other names
Pine Valley Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTEN TOI INMAN (OFFICE MANAGER)
(910) 425-2273
Entity
Organization
Contact information
Practice address
1661 OWEN DR, FAYETTEVILLE, NC 28304-3425
(910) 485-2273
(910) 485-0772
Mailing address
1661 OWEN DR, FAYETTEVILLE, NC 28304-3425
(910) 485-2273
(910) 485-0772
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6315
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
767829
UNITED CONCORDIA
NC
05
—
8990477
—
NC
01
—
90477
BLUE CROSS OF NC
NC
Enumeration date
03/05/2008
Last updated
10/29/2014
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