Individual
MR. STEPHEN RICHARD BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4106 6TH AVE, KEARNEY, NE 68848-3198
(308) 237-3479
(308) 236-9642
Mailing address
4106 6TH AVE, PO BOX 3198, KEARNEY, NE 68848-3198
(308) 237-3479
(308) 236-9642
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5333
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47055213001
—
NE
Enumeration date
10/27/2006
Last updated
07/08/2007
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