Organization
WAUSAU SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AARON J BUSHONG DDS (OWNER)
(715) 573-3868
Entity
Organization
Contact information
Practice address
705 S 24TH AVE, WAUSAU, WI 54401-5242
(715) 842-3933
Mailing address
705 S 24TH AVE, WAUSAU, WI 54401-5242
(715) 842-3933
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6524-15
WI
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871813329
INDIVIDUAL NPI
WI
Enumeration date
07/01/2014
Last updated
11/12/2024
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