Provider Demographics
NPI:1285718700
Name:BUSE, DACIANA (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:DACIANA
Middle Name:
Last Name:BUSE
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15955 NE 85TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3550
Mailing Address - Country:US
Mailing Address - Phone:425-883-2933
Mailing Address - Fax:425-885-0146
Practice Address - Street 1:15955 NE 85TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3550
Practice Address - Country:US
Practice Address - Phone:425-883-2933
Practice Address - Fax:425-885-0146
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000107051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice