Individual
MARVIN THOMAS BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1098 S MAYO TRL, SUITE 103, PIKEVILLE, KY 41501-1546
(606) 478-2413
Mailing address
1098 S MAYO TRL, SUITE 103, PIKEVILLE, KY 41501-1546
(606) 478-2413
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5000
KY
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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