Individual
MATTHEW LEE BUSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3407 BERRYWOOD DR STE 200, COLUMBIA, MO 65201-6500
(573) 603-1460
Mailing address
336 BROOKLYN AVE APT 1, KANSAS CITY, MO 64124-2985
(816) 315-7432
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2018017587
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018017587
MISSOURI STATE LICENSE
MO
Enumeration date
06/04/2018
Last updated
08/05/2024
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