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NPI Code Detail

MEDICARE: HANY BASTA DDS

MEDICARE:   HANY  BASTA  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist103464CA

General Provider Information

NPI Number : 1538632013
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANY BASTA DDS
Provider Business Mailing Address
First Line : 4401 FLORIN RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95823-2511
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4401 FLORIN RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95823-2511
Country : US
Telephone Number : 916-384-0950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2019
Last Update Date : 01/07/2019

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Directions to “ HANY BASTA DDS” Practice Location

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