Provider Demographics
NPI:1497974257
Name:JOHN B. BASSETT, DMD, PC
Entity Type:Organization
Organization Name:JOHN B. BASSETT, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL AND MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-893-8630
Mailing Address - Street 1:32 STILES RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2892
Mailing Address - Country:US
Mailing Address - Phone:603-893-8630
Mailing Address - Fax:603-893-3697
Practice Address - Street 1:32 STILES RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2892
Practice Address - Country:US
Practice Address - Phone:603-893-8630
Practice Address - Fax:603-893-3697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH89192010Medicaid
NHT25622Medicare UPIN
NHNH2010Medicare ID - Type Unspecified