JACOB KENNETH BUSHNELL

ASTORIA, OR
NPI1811401441
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: OR  D10727)
Enumeration Date2017-11-17
Last Update Date2017-11-17
Business Address
JACOB KENNETH BUSHNELL DDS
1414 MARINE DR
ASTORIA, OR 97103-3808
Phone number: 503-325-0310
Mailing Address
JACOB KENNETH BUSHNELL DDS
1414 MARINE DR
ASTORIA, OR 97103-3808
Phone number: 503-325-0310
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