Individual
BASMAN KRAIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7165 PEACH ST, ERIE, PA 16509-4764
(814) 864-1500
Mailing address
2258 LAKEVIEW DR, ERIE, PA 16506-6401
(619) 277-2911
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600407
MI
1223G0001X
General Practice Dentistry
DS041818
PA
Other
Enumeration date
07/09/2018
Last updated
03/16/2022
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