Individual
MALISSA A BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1101 5TH ST, 21ST DENTAL CLINIC, KAILUA, HI 96734
(808) 257-3365
Mailing address
1720 ALA MOANA BLVD APT F201, HONOLULU, HI 96815-1356
(757) 692-9906
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902016933
MI
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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