Individual
JEFFREY BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5303 S CEDAR ST, LANSING, MI 48911-3800
(517) 887-4423
Mailing address
5303 S CEDAR ST, LANSING, MI 48911-3800
(517) 887-4423
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901014946
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
743495529
—
MI
Enumeration date
10/06/2006
Last updated
06/24/2014
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