Individual
DR. DAVID C BASTACKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
516 N ROLLING RD, SUITE 104, BALTIMORE, MD 21228-4140
(410) 744-4222
(410) 744-2472
Mailing address
516 N ROLLING RD, SUITE 104, BALTIMORE, MD 21228-4140
(410) 744-4222
(410) 744-2472
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
10337
MD
Other
Enumeration date
07/01/2005
Last updated
09/02/2021
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