Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | OMS PERMIT #42 | CA |
NPI | 1053534339 |
---|---|
Provider Name | Dr. Marc Howard Bienstock |
First Address | Santa Barbara, CA 93105-3050 |
Second Address | Santa Barbara, CA 93101-2416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |