Provider Demographics
NPI:1922439462
Name:DR.'S BUSH AND MASON, INC.
Entity Type:Organization
Organization Name:DR.'S BUSH AND MASON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-615-4169
Mailing Address - Street 1:5527 OHIO RIVER RD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-9203
Mailing Address - Country:US
Mailing Address - Phone:304-675-6012
Mailing Address - Fax:
Practice Address - Street 1:5527 OHIO RIVER RD
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-9203
Practice Address - Country:US
Practice Address - Phone:304-675-6012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV39871223G0001X
WV22601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty