Provider Demographics
NPI:1427151653
Name:BUERSCHEN, GREGORY HERMAN (DDS)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:HERMAN
Last Name:BUERSCHEN
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N. WESTWOOD BLVD.
Mailing Address - Street 2:MAIL CODE 160
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901
Mailing Address - Country:US
Mailing Address - Phone:573-300-2117
Mailing Address - Fax:
Practice Address - Street 1:1500 N. WESTWOOD BLVD.
Practice Address - Street 2:MAIL CODE 160
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901
Practice Address - Country:US
Practice Address - Phone:573-300-2117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300213101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice