| Bussick Orthodontics | |
|
7207 Engle Rd Fort Wayne IN 46804-2231 | |
| (260) 436-2255 | |
| (260) 432-5466 |
| Full Name | Bussick Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 7207 Engle Rd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Timothy Jay Bussick (PRESIDENT/CEO) |
| Authorized Official Contact | 2604362255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bussick Orthodontics 7207 Engle Rd Fort Wayne IN 46804-2231 Ph: (260) 436-2255 | Bussick Orthodontics 7207 Engle Rd Fort Wayne IN 46804-2231 Ph: (260) 436-2255 |
| NPI Number | 1255427480 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 04/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255427480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 12009656 (Indiana) | Primary |
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