NPI | 1699030478 |
---|---|
Former Legal Business Name | MARTHA BUSTILLO, D.M.D. |
Entity Type | Organization |
Authorized Contact | MARTHA BUSTILLO Dmd 301-345-2222 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 12200) |
Enumeration Date | 2012-07-09 |
Last Update Date | 2016-09-26 |