Individual
DR. DAMARIS DERECE BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
101 DEVANT ST STE 404, FAYETTEVILLE, GA 30214-2713
(678) 884-5352
Mailing address
101 DEVANT ST STE 404, FAYETTEVILLE, GA 30214-2713
(678) 884-5352
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5087
LA
1223G0001X
General Practice Dentistry
Primary
DN015482
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1850870
—
LA
Enumeration date
09/19/2012
Last updated
11/08/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us