Individual
DR. IRA EDWIN BASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
439 60TH ST, WEST NEW YORK, NJ 07093-2211
(201) 861-6467
Mailing address
230 HIGHWOOD AVE, TENAFLY, NJ 07670-1208
(201) 568-7123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI009098
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012806
DORAL
NJ
01
—
0456501
UNISYS
NJ
01
—
1024469
HORIZON NJ HEALTH
NJ
Enumeration date
01/26/2007
Last updated
07/08/2007
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