Provider Demographics
NPI:1386802494
Name:TIFFANY L. BULLER-SCHUSSLER, DDS, PLC
Entity type:Organization
Organization Name:TIFFANY L. BULLER-SCHUSSLER, DDS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:BULLER-SCHUSSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:859-653-0525
Mailing Address - Street 1:1960 N BEND RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-9125
Mailing Address - Country:US
Mailing Address - Phone:859-653-0525
Mailing Address - Fax:859-689-1140
Practice Address - Street 1:1960 N BEND RD
Practice Address - Street 2:SUITE A
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-9125
Practice Address - Country:US
Practice Address - Phone:859-653-0525
Practice Address - Fax:859-689-1140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-26
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8558261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental