Bast, Kelly Catherine
Bast, Kelly Catherine is an individual health care provider with primary practice located at 3112 Airport Way Ste 1 , Fairbanks AK 99709-4768. She recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Dentist. Dental Providers / Oral and Maxillofacial Surgery is her primary health care specialty. Bast, Kelly Catherine can be contacted via phone (907) 452-1250.Contact Information
Primary practice address
3112 Airport Way Ste 1
Fairbanks AK 99709-4768
Phone: (907) 452-1250
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 1188 | Alaska |
| Dental Providers / Dentist | 122300000X | 1188 | Alaska |
Profile Details
| NPI number | 1740358753 |
|---|---|
| LBN Legal business name | Bast, Kelly Catherine |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2006 |
| Last updated | Sep 6th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740358753 | NPPES |
| Alaska | Other | 1188 | STATE OF ALASKA LIC. |
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