Individual
DR. JORGE A. BASTIDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
904 POMPTON AVE, SUITE A-1, CEDAR GROVE, NJ 07009-1262
(973) 857-0222
(973) 857-9508
Mailing address
904 POMPTON AVE, SUITE A-1, CEDAR GROVE, NJ 07009-1262
(973) 857-0222
(973) 857-9508
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI-017854
NJ
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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