Individual
BRENT MICHAEL HUMESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DD
Contact information
Practice address
10833 LE CONTE AVE RM 20-140, LOS ANGELES, CA 90095-1446
(209) 499-1179
Mailing address
10833 LE CONTE AVE RM 20-140, LOS ANGELES, CA 90095-3075
(209) 499-1179
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
110229
CA
Other
Enumeration date
06/06/2023
Last updated
05/03/2025
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