Individual
JEFFREY KENT BASTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
401 N LAKEVIEW ST, STURGIS, MI 49091-1229
(269) 651-1716
(269) 651-1717
Mailing address
401 N LAKEVIEW ST, STURGIS, MI 49091-1229
(269) 651-1716
(269) 651-1717
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
013588
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487241
—
MI
Enumeration date
01/26/2006
Last updated
07/08/2007
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