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Individual
DR. JILL BUSSEY
Active
Individual
DR. JILL BUSSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D., P.C.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401007197
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266086
ANTHEM
—
01
—
846274
UNITED CONCORDIA
—
Enumeration date
09/11/2007
Last updated
09/11/2007
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