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General NPI Number Information
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NPI Number | 1851468656
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Entity Type | Individual
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Provider Name | DENNIS EDWARD BUSHON DDS
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3515 ROCHESTER RD
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City | TROY
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State | MI
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Zip | 48083-5212
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Country | US
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Telephone | 248-689-2041
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 ROCHESTER RD
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City | TROY
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State | MI
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Zip | 48083-5212
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Country | US
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Telephone | 248-689-2041
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2901009527
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License Number State | MI
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