Individual
MARK E BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4112 6TH AVE, KEARNEY, NE 68845-3395
(308) 236-9694
(308) 237-4414
Mailing address
4112 6TH AVE, KEARNEY, NE 68845-3395
(308) 236-9694
(308) 237-4414
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5425
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-0696645-12
—
NE
Enumeration date
03/06/2007
Last updated
07/08/2007
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