Individual
ALEXANDER BASCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
17815 CHATSWORTH ST, GRANADA HILLS, CA 91344-5632
(818) 363-7552
Mailing address
11760 CHIMINEAS AVE, NORTHRIDGE, CA 91326-3612
(818) 368-5805
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
36334
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36334
—
CA
Enumeration date
01/04/2007
Last updated
07/09/2007
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