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General NPI Number Information
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NPI Number | 1093968075
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Entity Type | Organization
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Legal Business Name | MARCUS B. BUSKILL, DDS, PC
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 200 ALLEGHENY STREET
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City | RICHLANDS
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State | VA
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Zip | 24641-0880
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Country | US
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Telephone | 276-963-3705
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 880
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City | RICHLANDS
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State | VA
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Zip | 24641-0880
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Country | US
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Telephone | 276-963-3705
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MR. MARCUS BRANDON BUSKILL
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Credential | DDS
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Telephone | 276-963-3705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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