MICHAEL JOHN BASISTA

FORT MYERS, FL
NPI1780944629
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: FL  DN6721)
Enumeration Date2012-05-25
Last Update Date2012-05-25
Business Address
Dr. MICHAEL JOHN BASISTA D.D.S.
2454 WINKLER AVE.
FORT MYERS, FL 33901-9266
Phone number: 239-936-3866
Mailing Address
Dr. MICHAEL JOHN BASISTA D.D.S.
2454 WINKLER AVE.
FORT MYERS, FL 33901-9266
Phone number: 239-936-3866
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