Individual
DR. NEAL EDEN BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSD
Contact information
Practice address
15224 MAIN ST STE 302, MILL CREEK, WA 98012-7332
(425) 385-2641
Mailing address
15224 MAIN ST STE 302, MILL CREEK, WA 98012-7332
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE60788479
WA
Other
Enumeration date
01/03/2019
Last updated
01/03/2019
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