Individual
DR. JOHN RENOUARD CUSHING JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4216 PONTIAC LAKE ROAD, GREAT EXPRESSIONS, WATERFORD, MI 48328
(248) 674-1009
(248) 674-9615
Mailing address
1976 WARBLER CT, TROY, MI 48084
(248) 649-1498
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11243
MI
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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