Provider Demographics
NPI:1457328452
Name:BASSIN, ALFRED SCOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:SCOTT
Last Name:BASSIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 DAISY LN
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2224
Mailing Address - Country:US
Mailing Address - Phone:845-270-1989
Mailing Address - Fax:
Practice Address - Street 1:235 DAISY LN
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2224
Practice Address - Country:US
Practice Address - Phone:845-270-1989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice