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Organization

HOMESTEAD MODERN DENTISTRY, PA

Active
Other names
Homestead Modern Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CYNTHIA BUSTILLO DMD (OWNER)
(786) 410-6656
Entity
Organization

Contact information

Practice address
805 N HOMESTEAD BLVD, HOMESTEAD, FL 33030-5024
(786) 410-6656
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
12/13/2019
Last updated
05/11/2022
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