Individual
CHARLES U BASSO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
457 E GRAND AVE, SUITE 4, ESCONDIDO, CA 92025-3353
(760) 747-7878
(760) 747-2156
Mailing address
457 E GRAND AVE, SUITE 4, ESCONDIDO, CA 92025-3353
(760) 747-7878
(760) 747-2156
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46240
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42640
STATE LICENSE #
CA
Enumeration date
10/25/2005
Last updated
07/08/2007
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