Individual
DR. CARL LEE BASS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
646 SIGNAL HILL DRIVE EXT, STATESVILLE, NC 28625-4353
(704) 873-3321
Mailing address
646 SIGNAL HILL DRIVE EXT, STATESVILLE, NC 28625-4353
(704) 873-3321
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6420
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
467563
UNITED CONCORDIA
NC
01
—
90511
BCBSNC
NC
Enumeration date
07/25/2006
Last updated
07/08/2007
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