Organization
BRETT A. BASS, DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT ALAN BASS DDS (OWNER)
(907) 486-3291
Entity
Organization
Contact information
Practice address
1317 MILL BAY RD, KODIAK, AK 99615-6411
(907) 486-3291
(907) 486-3015
Mailing address
1317 MILL BAY RD, KODIAK, AK 99615-6411
(907) 486-3291
(907) 486-3015
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D948
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
886257
UNITED CONCORDIA
AK
05
—
DD02942
—
AK
Enumeration date
07/02/2008
Last updated
07/02/2008
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