Bush, Dr. P.A.
Dentist, General Practice in Lutz, FL. Organization (NPI-2).
NPI number1114136256
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1114136256
- Entity type
- Organization (NPI-2)
- Legal business name
- Bush, Dr. P.A.
- Organization subpart
- No
- Enumeration date
- May 22, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DN14833 | FL | Yes |
Other names
- Perfect Smile Dental Studio (Doing Business As)
Practice location
24632 State Road 54Lutz, FL 33559-7307
Phone 813-948-6335 · Fax 813-948-6394
Mailing address
24632 State Road 54Lutz, FL 33559-7307
Phone 813-948-6335 · Fax 813-948-6394
Authorized official
Ana Maria Bush
Owner
8139486335
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