Provider Demographics
NPI:1790301513
Name:BHUSARI, RISHI MANISH (DMD)
Entity Type:Individual
Prefix:DR
First Name:RISHI
Middle Name:MANISH
Last Name:BHUSARI
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 1:9 TRIANGLE PARK DR # 3
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5790
Mailing Address - Country:US
Mailing Address - Phone:603-225-6331
Mailing Address - Fax:
Practice Address - Street 1:9 TRIANGLE PARK DR # 3
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5790
Practice Address - Country:US
Practice Address - Phone:603-225-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04567122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist