Provider Demographics
NPI:1750770392
Name:BASSETT, ALEXANDRA (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:BASSETT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-2938
Mailing Address - Country:US
Mailing Address - Phone:954-232-0369
Mailing Address - Fax:
Practice Address - Street 1:677 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-2938
Practice Address - Country:US
Practice Address - Phone:303-955-6079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00202416122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist