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Individual

DR. MANUEL ANTHONY BUSTAMANTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
11645 WILSHIRE BLVD, SUITE 1160, LOS ANGELES, CA 90025-6811
(310) 473-5559
Mailing address
11645 WILSHIRE BLVD, SUITE 1160, LOS ANGELES, CA 90025-6811
(310) 473-5559

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
29218
CA

Other

Enumeration date
07/27/2010
Last updated
07/27/2010
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