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Individual

JOHN BUSHROD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3863 ALABAMA AVE SE, WASHINGTON, DC 20020-1001
(202) 800-4488
(202) 771-4966
Mailing address
6710 OXON HILL RD STE 170, OXON HILL, MD 20745-1123
(301) 686-0710

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17246
MD
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DEN2000106
DC

Other

Enumeration date
10/13/2021
Last updated
04/08/2025
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