Individual
CAROLYN D BUSTILLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
BUILDING N-46 CAPE SARICHEF, KODIAK, AK 99619-5002
(907) 487-5757
(907) 487-5360
Mailing address
BUILDING N-46 CAPE SARICHEF, KODIAK, AK 99619-5002
(907) 487-5757
(907) 487-5360
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
38985
CA
Other
Enumeration date
03/24/2009
Last updated
03/24/2009
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