Provider Demographics
NPI:1639281694
Name:BHASKAR, PHILIP B (DMD)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:B
Last Name:BHASKAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:335 EL DORADO STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-372-2882
Mailing Address - Fax:831-655-6434
Practice Address - Street 1:335 EL DORADO STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-372-2882
Practice Address - Fax:831-655-6434
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA322731223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery