Individual
DR. JENNA BUSHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
7455 W CREST LN, GLENDALE, AZ 85310-5623
(503) 989-0693
Mailing address
7455 W CREST LN, GLENDALE, AZ 85310-5623
(503) 989-0693
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D011210
AZ
Other
Enumeration date
10/23/2021
Last updated
10/23/2021
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