Provider Demographics
NPI:1437951399
Name:HASBUN AESTHETIC DENTAL GROUP PC
Entity type:Organization
Organization Name:HASBUN AESTHETIC DENTAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASBUN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-270-1134
Mailing Address - Street 1:5757 WILSHIRE BLVD STE 503
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5812
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5757 WILSHIRE BLVD STE 503
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5812
Practice Address - Country:US
Practice Address - Phone:310-904-9969
Practice Address - Fax:310-694-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental