Provider Demographics
NPI:1275640633
Name:DONALD H BUSBY DMD PC
Entity Type:Organization
Organization Name:DONALD H BUSBY DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:HERBERT
Authorized Official - Last Name:BUSBY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-864-8808
Mailing Address - Street 1:134 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36862
Mailing Address - Country:US
Mailing Address - Phone:334-864-8808
Mailing Address - Fax:334-864-8840
Practice Address - Street 1:134 1ST ST SE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:AL
Practice Address - Zip Code:36862
Practice Address - Country:US
Practice Address - Phone:334-864-8808
Practice Address - Fax:334-864-8840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty