| Bush Pediatric Dentistry | |
|
4740 Woodmere Blvd Montgomery AL 36106-3065 | |
| (334) 676-2144 | |
| (334) 676-2148 |
| Full Name | Bush Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4740 Woodmere Blvd, Montgomery, Alabama |
| Authorized Official Name and Position | Samuel Wayne Bush (DENTIST/OWNER) |
| Authorized Official Contact | 3345040142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bush Pediatric Dentistry 3420 Lansdowne Dr Montgomery AL 36111-2115 Ph: (334) 504-0142 | Bush Pediatric Dentistry 4740 Woodmere Blvd Montgomery AL 36106-3065 Ph: (334) 676-2144 |
| NPI Number | 1578091815 |
|---|---|
| Provider Enumeration Date | 05/31/2017 |
| Last Update Date | 05/31/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578091815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 6240 (Alabama) | Primary |
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