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Organization
BUSHONG DENTAL, PLLC
Active
Organization
BUSHONG DENTAL, PLLC
Active
Other names
Dominion Dental Spa, Dominion Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PERRY J BUSHONG II DDS (PRESIDENT)
(817) 851-3291
Entity
Organization
Contact information
Practice address
4 DOMINION DR # 250, SAN ANTONIO, TX 78257-1390
(210) 687-1150
Mailing address
14806 CIRCLE J TRL, HELOTES, TX 78023-3829
(817) 851-3291
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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