| NPI | 1659177434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A BUSTO Managing Member 346-558-5881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2025-02-21 |
| Last Update Date | 2026-02-05 |