Most Relevant Information
Provider Data
| NPI Number: | 1003475161 |
| Provider Name: | CAROLINE W. L. BASTA D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 24833 |
Most Important Dates
| Enumeration Date: | 06/11/2019 |
| Last Updated: | 08/01/2024 |
Provider Practice Location
4063 N GOLDENROD RD STE 4
WINTER PARK
FL
327928905
Practice Location Phone/Fax
| Phone: | 4076778888 |
| Fax: |
Provider Mailing Location
2044 WOOD THRUSH LN
WINTER PARK
FL
327923164
Provider Mailing Phone/Fax
| Phone: | 7026014714 |
| Fax: |