Individual
DR. NICHOLAS BUSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1313 E 20TH ST, OKMULGEE, OK 74447-6303
(918) 591-5721
Mailing address
1313 E 20TH ST, OKMULGEE, OK 74447-6303
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
7414
OK
1223G0001X
General Practice Dentistry
7414
OK
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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