Provider Demographics
NPI:1588810741
Name:RUSHER, PHILLIP D (DMD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:D
Last Name:RUSHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 BLOSSOM PARK DR STE 1
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8075
Mailing Address - Country:US
Mailing Address - Phone:502-570-8778
Mailing Address - Fax:502-570-8878
Practice Address - Street 1:240 BLOSSOM PARK DR STE 1
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8075
Practice Address - Country:US
Practice Address - Phone:502-570-8778
Practice Address - Fax:502-570-8878
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8612122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist