Provider Demographics
NPI:1861807224
Name:DANIELL J. BUSE, D.D.S., LLC
Entity type:Organization
Organization Name:DANIELL J. BUSE, D.D.S., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELL
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:308-258-0619
Mailing Address - Street 1:7706 NW CADWALLADER RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3011
Mailing Address - Country:US
Mailing Address - Phone:308-258-0619
Mailing Address - Fax:
Practice Address - Street 1:240 S STATE ROUTE C
Practice Address - Street 2:
Practice Address - City:PECULIAR
Practice Address - State:MO
Practice Address - Zip Code:64078-9729
Practice Address - Country:US
Practice Address - Phone:816-779-6500
Practice Address - Fax:816-758-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120147151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty