Bustamante Endodontics Adc
Dentist, Endodontics in Los Angeles, CA. Organization (NPI-2).
NPI number1710074513
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1710074513
- Entity type
- Organization (NPI-2)
- Legal business name
- Bustamante Endodontics Adc
- Organization subpart
- No
- Enumeration date
- Oct 5, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223E0200X | Dentist, Endodontics | 29218 | CA | Yes |
Practice location
11645 Wilshire BlvdSuite 1160
Los Angeles, CA 90025-6811
Phone 310-473-5559
Mailing address
11645 Wilshire BlvdSuite 1160
Los Angeles, CA 90025-6811
Phone 310-473-5559
Authorized official
Manuel A. Bustamante
President
3104735559
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