Organization
CORAZON V. BUSTOS, D.M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CORAZON VIRATA BUSTOS SR. D.M.D. (PRESIDENT)
(626) 962-3353
Entity
Organization
Contact information
Practice address
4322 N. MAINE AVE, BALDWIN PARK, CA 91706-3314
(626) 962-3353
(626) 962-3353
Mailing address
4322 N. MAINE AVE, BALDWIN PARK, CA 91706-3314
(626) 962-3353
(626) 962-3353
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
CA
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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