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General NPI Number Information
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NPI Number | 1790139913
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Entity Type | Organization
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Legal Business Name | BUSHMAN DENTAL CARE P.C.
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 04/14/2016
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Provider Practice Location Address
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Address Line | 400 E US HIGHWAY 70
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City | SAFFORD
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State | AZ
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Zip | 85546-2046
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Country | US
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Telephone | 928-348-8884
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Fax | 928-348-8480
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Provider Business Mailing Address
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Address Line | 400 E US HIGHWAY 70
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City | SAFFORD
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State | AZ
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Zip | 85546-2046
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Country | US
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Telephone | 928-348-8884
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Fax | 928-348-8480
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRUCE BURTON BUSHMAN
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Credential | DDS
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Telephone | 928-348-8884
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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 | 4783
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License Number State | AZ
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