Organization
FAMILY ORTHODONTICS
Active
Organization
FAMILY ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL BASS DMD, MS (ORTHODONTIST)
(561) 762-6200
Entity
Organization
Contact information
Practice address
12797 FOREST HILL BLVD, SUITE 6A, WELLINGTON, FL 33414-4763
(561) 762-6200
Mailing address
12797 FOREST HILL BLVD, SUITE 6A, WELLINGTON, FL 33414-4763
(561) 762-6200
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN 18630
FL
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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