Provider Demographics
NPI:1831387356
Name:CUSHNER, STUART C (DMD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:C
Last Name:CUSHNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2 KNOTTY WALK
Mailing Address - Street 2:PO BOX 2791
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3249
Mailing Address - Country:US
Mailing Address - Phone:508-824-8030
Mailing Address - Fax:508-822-8015
Practice Address - Street 1:2 KNOTTY WALK
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3249
Practice Address - Country:US
Practice Address - Phone:508-824-8030
Practice Address - Fax:508-822-8015
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153141223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics