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General NPI Number Information
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NPI Number | 1770782039
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Entity Type | Individual
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Provider Name | RICHARD JEAN-PIERRE BASTIEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 1433 PIEDMONT DR E
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City | TALLAHASSEE
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State | FL
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Zip | 32308-7943
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Country | US
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Telephone | 850-425-1300
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Fax | 850-219-1527
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Provider Business Mailing Address
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Address Line | 6599 LAKE PISGAH DR
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City | TALLAHASSEE
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State | FL
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Zip | 32309-2086
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Country | US
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Telephone | 850-566-2972
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Fax | 850-219-1527
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN17786
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN-17786
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License Number State | FL
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