Provider Demographics
NPI:1487668596
Name:BUSCH, MATTHEW J (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:BUSCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1701 E WOODFIELD RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5905
Mailing Address - Country:US
Mailing Address - Phone:847-517-1333
Mailing Address - Fax:847-517-7594
Practice Address - Street 1:1701 E WOODFIELD RD
Practice Address - Street 2:SUITE 500
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5905
Practice Address - Country:US
Practice Address - Phone:847-517-1333
Practice Address - Fax:847-517-7594
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics