Bastic, Robert James

Bastic, Robert James is an sole proprietor health care provider with primary practice located at 335 E Wisconsin Ave , Appleton WI 54911-4821. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Bastic, Robert James can be contacted via phone (920) 734-1803.

Contact Information

Primary practice address
335 E Wisconsin Ave Appleton WI 54911-4821
Phone: (920) 734-1803
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2373 Wisconsin

Profile Details

NPI number 1811074040
LBN Legal business name Bastic, Robert James
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811074040 NPPES
Wisconsin MEDICAID 33395400

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