IndividualActive
Adam De La Bastide, DDS
NPI 1376382978 · Student in an Organized Health Care Education/Training Program · Mineola, NY
Provider details
- NPI number
- 1376382978
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Student, Health Care
Practice location
200 Old Country Rd
Mineola, NY 11501-4235
Phone: (516) 663-2752
Approximate (ZIP-level) locationGet directions
Mailing address
2 Durham Dr
Dix Hills, NY 11746-5311
Registry dates
- Enumerated
- 2024-05-22
- Last updated
- 2024-05-22
- Certified
- 2024-05-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.