Provider Demographics
NPI:1548505373
Name:PAUL D. BUSSMAN, D.M.D. P.C.
Entity type:Organization
Organization Name:PAUL D. BUSSMAN, D.M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PRIVETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-734-1700
Mailing Address - Street 1:1625 MAIN AVE SW
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-5230
Mailing Address - Country:US
Mailing Address - Phone:256-734-1700
Mailing Address - Fax:256-739-1984
Practice Address - Street 1:1625 MAIN AVE SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5230
Practice Address - Country:US
Practice Address - Phone:256-734-1700
Practice Address - Fax:256-739-1984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty