Individual
DR. GARY BRUCE NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1940 BRAEBURN DR, SALEM, VA 24153-7383
(540) 989-5257
Mailing address
1940 BRAEBURN DR, SALEM, VA 24153-7383
(540) 989-5257
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401005223
VA
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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