Individual
DR. BRETT ALAN BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PC
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
1223G0001X
General Practice Dentistry
Primary
12009451
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
886257
UCCI PROVIDER NUMBER
AK
05
—
DD02941
—
AK
Enumeration date
08/05/2006
Last updated
07/09/2007
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