Individual
DR. THOMAS LUKE BASHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
710 DODGE AVE NW, SUITE B, ELK RIVER, MN 55330-2019
(763) 441-3922
Mailing address
710 DODGE AVE NW, SUITE B, ELK RIVER, MN 55330-2019
(763) 441-3922
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D09824
MN
Other
Enumeration date
04/27/2006
Last updated
08/19/2014
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