Individual
BRANDON BUSHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6660
Mailing address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6660
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2012015439
MO
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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