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General NPI Number Information
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NPI Number | 1992824379
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Entity Type | Organization
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Legal Business Name | JOSEPH P. BASLICE D.D.S.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 34 LUCILLE LN
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City | DIX HILLS
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State | NY
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Zip | 11746-5810
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Country | US
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Telephone | 631-673-6723
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Fax | 631-427-1931
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Provider Business Mailing Address
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Address Line | 34 LUCILLE LN
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City | DIX HILLS
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State | NY
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Zip | 11746-5810
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Country | US
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Telephone | 631-673-6723
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Fax | 631-427-1931
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH PARKMAN BASILICE
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Credential | D.D.S.
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Telephone | 631-673-6723
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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 | 034844
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License Number State | NY
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