Provider Demographics
NPI:1043384266
Name:VANBUSKIRK, DANIEL BRIAN (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BRIAN
Last Name:VANBUSKIRK
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 COLEMAN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1371
Mailing Address - Country:US
Mailing Address - Phone:701-751-8081
Mailing Address - Fax:701-751-0836
Practice Address - Street 1:4401 COLEMAN ST STE 104
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1371
Practice Address - Country:US
Practice Address - Phone:701-751-8081
Practice Address - Fax:701-751-0836
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005-007420122300000X
ND1892122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist