Provider Demographics
NPI:1043585078
Name:STEPHANIE M BUSCH-ABBATE, DDS, PLC
Entity Type:Organization
Organization Name:STEPHANIE M BUSCH-ABBATE, DDS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUSCH-ABBATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-381-3890
Mailing Address - Street 1:3048 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-2956
Mailing Address - Country:US
Mailing Address - Phone:269-381-3890
Mailing Address - Fax:269-381-9743
Practice Address - Street 1:3048 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-2956
Practice Address - Country:US
Practice Address - Phone:269-381-3890
Practice Address - Fax:269-381-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty