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Individual

DR. JEFFREY L BASSETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
108 S TOWNLINE RD, LAGRANGE, IN 46761-1740
(260) 463-3652
(260) 463-7096
Mailing address
108 S TOWNLINE RD, LAGRANGE, IN 46761-1740
(260) 463-3652
(260) 463-7096

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008295
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100159740-A
IN
Enumeration date
11/28/2006
Last updated
12/22/2016
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