Busch, Robert John
Busch, Robert John is an individual health care provider with primary practice located at 2807 N Knoxville Ave , Peoria IL 61604-2869. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Busch, Robert John can be contacted via phone (309) 682-1213.Contact Information
Primary practice address
2807 N Knoxville Ave
Peoria IL 61604-2869
Phone: (309) 682-1213
Fax: (309) 682-1213
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 0021934 | Texas |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | BP10028831 | Texas |
Profile Details
| NPI number | 1467669762 |
|---|---|
| LBN Legal business name | Busch, Robert John |
| Credentials | DMD MD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2007 |
| Last updated | Aug 12th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467669762 | NPPES |
| Texas | MEDICAID | 177585009 | |
| Texas | Other | 1467669762 | |
| Texas | MEDICAID | 177585010 | |
| Texas | Other | 21934 | |
| Texas | Other | BP10028831 |
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