Individual
MRS. TRACY S BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
274 WHITTLE CIR, ASHBURN, GA 31714-1918
(229) 567-4316
(229) 567-4316
Mailing address
462 RED OAK RD, TIFTON, GA 31793-5333
(229) 567-4316
(229) 567-4316
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH005972
GA
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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