Organization
THE HAVEN FAMILY AND COSMETIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NITCHEL BASTIEN DMD (DENTIST/OWNER)
(410) 881-7447
Entity
Organization
Contact information
Practice address
983 WAUGH CHAPEL WAY STE E, GAMBRILLS, MD 21054-1261
(410) 881-7447
Mailing address
983 WAUGH CHAPEL WAY STE E, GAMBRILLS, MD 21054-1261
(410) 881-7447
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2024
Last updated
10/04/2024
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