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Individual

DERRICK JAMES BUSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
4 SUNSET WAY, UNIT C, HENDERSON, NV 89014
(702) 376-9455
Mailing address
6524 CORONADO CANYON AVE, LAS VEGAS, NV 89142-2878
(702) 376-9455

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7646
NV

Other

Enumeration date
08/18/2022
Last updated
08/18/2022
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