Provider Demographics
NPI:1851523682
Name:COUTO, CRYSTIANE BABARCZI (MD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTIANE
Middle Name:BABARCZI
Last Name:COUTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12665 VILLAGE LN APT 3525
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2853
Mailing Address - Country:US
Mailing Address - Phone:314-724-8732
Mailing Address - Fax:
Practice Address - Street 1:24264 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2911
Practice Address - Country:US
Practice Address - Phone:661-290-2825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247991223X0400X
CA618841223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics