Individual
DR. BRENT R BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1717 SHIPYARD BLVD, SUITE 120, WILMINGTON, NC 28403-8019
(910) 313-1511
Mailing address
1717 SHIPYARD BLVD, SUITE 120, WILMINGTON, NC 28403-8019
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6805
NC
Other
Enumeration date
06/23/2006
Last updated
07/08/2007
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