Organization
UNIQUE SMILES
Active
Other names
TLC Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS R BUSH III DDS (DENTIST)
(505) 259-4550
Entity
Organization
Contact information
Practice address
8616 MENAUL BLVD NE, SUITE D, ALBUQUERQUE, NM 87112-2261
(505) 259-4550
Mailing address
8616 MENAUL BLVD NE, SUITE D, ALBUQUERQUE, NM 87112-2261
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2580
NM
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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