Individual
BRIAN BASTECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1507 BERMUDA RD, MARCO ISLAND, FL 34145-4003
(609) 915-8606
Mailing address
1507 BERMUDA RD, MARCO ISLAND, FL 34145-4003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI01659200
NJ
Other
Enumeration date
10/06/2021
Last updated
10/06/2021
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