Miguel Ismael Bustamante, DDS

NPI #1194160341 in Bolinas, California

Provider Information

NPI Number: 1194160341
Entity Type: Individual
Name: Miguel Ismael Bustamante, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: May 1, 2013
Last Updated: May 1, 2013

Practice Location

Address: 24 WHARF ROAD
City: Bolinas
State: California
ZIP Code: 94924
Phone: (415) 868-0911

Specialties & Taxonomy Codes

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

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