Provider Demographics
NPI:1972924983
Name:JAMES L. BUSH DDS, PC
Entity Type:Organization
Organization Name:JAMES L. BUSH DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-851-6800
Mailing Address - Street 1:911 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2309
Mailing Address - Country:US
Mailing Address - Phone:615-851-6800
Mailing Address - Fax:615-851-0392
Practice Address - Street 1:911 MEADOWLARK LN
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2309
Practice Address - Country:US
Practice Address - Phone:615-851-6800
Practice Address - Fax:615-851-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty