| NPI | 1750962056 |
|---|---|
| Professional Name | LEEDA BASSAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02874300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2022-04-19 |