Provider Demographics
NPI:1609033299
Name:BUSHI, PAUL LAWRENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:LAWRENCE
Last Name:BUSHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 CENTER ROAD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212
Mailing Address - Country:US
Mailing Address - Phone:330-225-4700
Mailing Address - Fax:
Practice Address - Street 1:3725 CENTER ROAD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212
Practice Address - Country:US
Practice Address - Phone:330-225-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30018450122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist