Brandon Bushong, D.D.S. Valid NPI
Individual provider · Dentist · Detroit, MI
- NPI
- 1336404078
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 2012015439 (MO)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2012-07-09
- Last updated
- 2012-07-09
Practice location
2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576
(313) 494-6660