Provider Demographics
NPI:1881993590
Name:RONALD BASSIUR D.D.S. P.C.
Entity type:Organization
Organization Name:RONALD BASSIUR D.D.S. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSIUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:516-487-8240
Mailing Address - Street 1:15 BOND ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2002
Mailing Address - Country:US
Mailing Address - Phone:516-487-8240
Mailing Address - Fax:516-482-2544
Practice Address - Street 1:15 BOND ST
Practice Address - Street 2:SUITE 210
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2002
Practice Address - Country:US
Practice Address - Phone:516-487-8240
Practice Address - Fax:516-482-2544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0238461261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental