Provider Demographics
NPI:1356735054
Name:BASS & KAMP, PLLC
Entity type:Organization
Organization Name:BASS & KAMP, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-951-7414
Mailing Address - Street 1:209 ROANOKE ST STE 6
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-3035
Mailing Address - Country:US
Mailing Address - Phone:540-382-3291
Mailing Address - Fax:
Practice Address - Street 1:209 ROANOKE ST STE 6
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-3035
Practice Address - Country:US
Practice Address - Phone:540-382-3291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty