Provider Demographics
NPI:1205944766
Name:BUSEY, ROBERT TIMOTHY (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TIMOTHY
Last Name:BUSEY
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 1:12 OLD FORT RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-9758
Mailing Address - Country:US
Mailing Address - Phone:828-628-3504
Mailing Address - Fax:828-628-3505
Practice Address - Street 1:12 OLD FORT RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-9758
Practice Address - Country:US
Practice Address - Phone:828-628-3504
Practice Address - Fax:828-628-3505
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5002122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC902H7OtherBCBS