Provider Demographics
NPI:1376779488
Name:BUSH, JENNIFER LINN (DMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LINN
Last Name:BUSH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 BYERS ROAD
Mailing Address - Street 2:C/O CHESTER SPRINGS FAMILY DENTISTRY
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425
Mailing Address - Country:US
Mailing Address - Phone:610-458-3800
Mailing Address - Fax:610-458-3904
Practice Address - Street 1:241 BYERS ROAD
Practice Address - Street 2:C/O CHESTER SPRINGS FAMILY DENTISTRY
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425
Practice Address - Country:US
Practice Address - Phone:610-458-3800
Practice Address - Fax:610-458-3904
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035579122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist