Individual
RICO BUSSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
450 COMMERCE DR # 431, PEACHTREE CITY, GA 30269-3517
(770) 448-8882
Mailing address
450 COMMERCE DR # 431, PEACHTREE CITY, GA 30269-3517
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
1427
FL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN015008
GA
Other
Enumeration date
07/04/2015
Last updated
09/11/2020
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