| NPI | 1780896613 |
|---|---|
| Other Name | SONIA BUSTOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA cert. no. 10466) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA 8973) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2009-01-22 |