Individual
LOUIS R BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8 MEDICAL CENTER RD, EDGEWOOD, NM 87015-7086
(505) 873-7405
(505) 873-7444
Mailing address
2001 CENTRO FAMILIAR BLVD SW, ALBUQUERQUE, NM 87105-4592
(505) 873-7405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD2580
NM
Other
Enumeration date
12/02/2005
Last updated
04/10/2009
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