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General NPI Number Information
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NPI Number | 1003362955
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Entity Type | Organization
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Legal Business Name | SHEN AND BUSQUETS DENTAL PARTNERSHIP
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Dates
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Enumeration Date | 08/31/2016
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 20600 LAKE CHABOT RD STE 205
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5432
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Country | US
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Telephone | 510-538-2566
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Fax |
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Provider Business Mailing Address
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Address Line | 20600 LAKE CHABOT RD STE 205
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5432
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Country | US
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Telephone | 510-538-2566
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Fax |
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Authorized Official
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Title or Position | PART-OWNER
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Name | DR. RICARDO BUSQUETS
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Credential | DMD,MS,CAGS
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Telephone | 510-538-2566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 55857
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License Number State | CA
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