Bast, Kelly Catherine

Bast, Kelly Catherine is an individual health care provider with primary practice located at 3112 Airport Way Ste 1 , Fairbanks AK 99709-4768. She recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Dentist. Dental Providers / Oral and Maxillofacial Surgery is her primary health care specialty. Bast, Kelly Catherine can be contacted via phone (907) 452-1250.

Contact Information

Primary practice address
3112 Airport Way Ste 1 Fairbanks AK 99709-4768
Phone: (907) 452-1250
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 1188 Alaska
Dental Providers / Dentist 122300000X 1188 Alaska

Profile Details

NPI number 1740358753
LBN Legal business name Bast, Kelly Catherine
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Sep 6th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740358753 NPPES
Alaska Other 1188 STATE OF ALASKA LIC.

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