Organization
WILLIAM J BUSACCA DDS, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEAH R HENDRICKSON (OFFICE MANAGER)
(360) 426-9711
Entity
Organization
Contact information
Practice address
1525 OLYMPIC HWY N, SHELTON, WA 98584-3049
(360) 426-9711
(360) 426-6361
Mailing address
1525 OLYMPIC HWY N, SHELTON, WA 98584-3049
(360) 426-9711
(360) 426-6361
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4275
WA
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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