Organization
DDSDMD, LLC
Active
Other names
Bastien Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD JEAN-PIERRE BASTIEN D.M.D. (OWNER)
(850) 566-2972
Entity
Organization
Contact information
Practice address
2621 MITCHAM DR, SUITE #102, TALLAHASSEE, FL 32308-5480
(850) 425-1300
(850) 219-1527
Mailing address
5716 FARNSWORTH DR, TALLAHASSEE, FL 32312-4881
(850) 566-2972
(850) 219-1527
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17786
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619274529
NPPES
FL
01
—
1770782039
NPPES
FL
Enumeration date
05/15/2012
Last updated
05/15/2012
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