NPI: 1780839639
Provider Name: EBENEZER BUSH, A PROFESSIONAL CORPORATION
Other Name: EBENEZER BUSH, DDS
Classification: Dentist - 1223S0112X
Entity Type: Organization
Specialization: Oral and Maxillofacial Surgery
Address:
609 S LONG BEACH BLVD
COMPTON, CA
ZIP 90221
Phone: (310) 638-1122
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EBENEZER BUSH, A PROFESSIONAL CORPORATION is an oral and maxillofacial surgery dentist in Compton, CA. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. EBENEZER BUSH, A PROFESSIONAL CORPORATION NPI is 1780839639. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Ebenezer Bush, Dds.
The provider's business location address is:
609 S LONG BEACH BLVD
COMPTON, CA
ZIP 90221-026
Phone: (310) 638-1122
Fax: (310) 638-7565
The provider's authorized official is Ebenezer Bush .
The authorized official title is Owner and has the following contact phone number (310) 638-1122.
The enumeration date for this NPI number is 11/19/2008 and was last updated on 11/19/2008.