| Clarence E. Bush, D.M.D., P.C. | |
|
144 Whigham Dairy Rd Bainbridge GA 39817-7833 | |
| (229) 246-9986 | |
| (229) 246-7492 |
| Full Name | Clarence E. Bush, D.M.D., P.C. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 144 Whigham Dairy Rd, Bainbridge, Georgia |
| Authorized Official Name and Position | Clarence Edward Bush (PRESIDENT) |
| Authorized Official Contact | 2292469986 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarence E. Bush, D.M.D., P.C. 144 Whigham Dairy Rd P.o. Box 878 Bainbridge GA 39817-7833 Ph: (229) 246-9986 | Clarence E. Bush, D.M.D., P.C. 144 Whigham Dairy Rd Bainbridge GA 39817-7833 Ph: (229) 246-9986 |
| NPI Number | 1760740831 |
|---|---|
| Provider Enumeration Date | 04/26/2012 |
| Last Update Date | 04/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760740831 | NPI | - | NPPES |
| 00824601A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 011667 (Georgia) | Primary |
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