Individual
TIMOTHY JAY BUSSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S; M.S.
Contact information
Practice address
7207 ENGLE RD, FORT WAYNE, IN 46804-2231
(260) 436-2255
(260) 432-5466
Mailing address
7207 ENGLE RD, FORT WAYNE, IN 46804-2231
(260) 436-2255
(260) 432-5466
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12009656A
IN
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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