DR. Angelica Jane Bustos Thacker, DMD

NPI #1073251963 in Las Vegas, Nevada

Provider Information

NPI Number: 1073251963
Entity Type: Individual
Name: DR. Angelica Jane Bustos Thacker, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: May 22, 2022
Last Updated: Mar 17, 2023

Practice Location

Address: 7603 GRAND TETON DR STE 140
City: Las Vegas
State: Nevada
ZIP Code: 89131-1602
Phone: (702) 957-1013

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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