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Organization

TIMOTHY JAY BUSSICK DDS, MS, INCORPORATED

Active
Other names
Bussick Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY JAY BUSSICK DDS, MS (PRESIDENT/CEO)
(260) 436-2255
Entity
Organization

Contact information

Practice address
7207 ENGLE RD, FORT WAYNE, IN 46804-2231
(260) 436-2255
(260) 432-5466
Mailing address
7207 ENGLE RD, FORT WAYNE, IN 46804-2231
(260) 436-2255
(260) 432-5466

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12009656
IN

Other

Enumeration date
10/05/2006
Last updated
04/09/2008
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