Hustafa, Marie L
Hustafa, Marie L is an sole proprietor health care provider with primary practice located at 281 Sawyer Dr , Durango CO 81303-3409. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Hustafa, Marie L can be contacted via phone (970) 247-5702.Contact Information
Primary practice address
281 Sawyer Dr
Durango CO 81303-3409
Phone: (970) 247-5702
Fax: (970) 247-9126
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 904555 | Colorado |
Profile Details
| NPI number | 1073669073 |
|---|---|
| LBN Legal business name | Hustafa, Marie L |
| Credentials | Registered Dental Hygienist (RDH) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 25th, 2007 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073669073 | NPPES |
| Colorado | MEDICAID | 80528201 |
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