Provider Demographics
NPI:1477662575
Name:BAKIR, MOSTAFA H (DMD)
Entity Type:Individual
Prefix:DR
First Name:MOSTAFA
Middle Name:H
Last Name:BAKIR
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 1:577 STERNBERG AVE
Mailing Address - Street 2:HQ U.S. ARMY DENTAL ACTIVITY CREDENTIALS OFFICE
Mailing Address - City:FORT EUSTIS
Mailing Address - State:VA
Mailing Address - Zip Code:23604-5311
Mailing Address - Country:US
Mailing Address - Phone:757-314-7944
Mailing Address - Fax:757-314-7942
Practice Address - Street 1:577 STERNBERG AVE
Practice Address - Street 2:HQ U.S. ARMY DENTAL ACTIVITY CREDENTIALS OFFICE
Practice Address - City:FORT EUSTIS
Practice Address - State:VA
Practice Address - Zip Code:23604-5311
Practice Address - Country:US
Practice Address - Phone:757-314-7944
Practice Address - Fax:757-314-7942
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036352122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist