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Individual

DR. DANIEL ARTHUR BASTIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(508) 583-4500
Mailing address
12 REVERE PL, MEDFORD, MA 02155-3903
(508) 517-0865

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4921
MA
152W00000X
Optometrist
OEG002619
PA

Other

Enumeration date
07/10/2012
Last updated
03/09/2016
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