Individual
DR. ROBERT JOHN BUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0021934
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10028831
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467669762
BLUE CROSS BLUE SHIELD
TX
05
—
177585009
—
TX
05
—
177585010
—
TX
01
—
21934
TX DENTAL
TX
01
—
BP10028831
PHYSICIAN IN TRAINING
TX
Enumeration date
05/17/2007
Last updated
08/12/2015
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