Provider Demographics
NPI:1700070133
Name:BUSBY, DONALD H (DMD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:H
Last Name:BUSBY
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 1:134 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36862-2304
Mailing Address - Country:US
Mailing Address - Phone:334-864-8808
Mailing Address - Fax:
Practice Address - Street 1:134 1ST ST SE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:AL
Practice Address - Zip Code:36862-2304
Practice Address - Country:US
Practice Address - Phone:334-864-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice