Individual
MRS. ISABEL BASTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
335 BROADWAY, LONG BRANCH, NJ 07740-6901
(732) 475-3800
(732) 483-6444
Mailing address
270 BROADWAY, LONG BRANCH, NJ 07740
(732) 391-2824
(732) 222-2700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02485500
NJ
122300000X
Dentist
DI02485500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0279463
—
NJ
Enumeration date
11/03/2011
Last updated
12/13/2018
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