Provider Demographics
NPI:1851315386
Name:MATTHEW J. BUSCH, D.D.S., LTD.
Entity Type:Organization
Organization Name:MATTHEW J. BUSCH, D.D.S., LTD.
Other - Org Name:DAVID R. MUSICH, D.D.S. & MATTHEW J. BUSCH, D.D.S. LTD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-517-1333
Mailing Address - Street 1:1701 E. WOODFIELD ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-517-1333
Mailing Address - Fax:847-517-7594
Practice Address - Street 1:1701 E. WOODFIELD ROAD
Practice Address - Street 2:SUITE 500
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-517-1333
Practice Address - Fax:847-517-7594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060-0021831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty