Provider Demographics
NPI:1871607309
Name:MAYBUSHER, FRANK WILLIAM (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:WILLIAM
Last Name:MAYBUSHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 CADELEIGH CT
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8925
Mailing Address - Country:US
Mailing Address - Phone:480-544-4491
Mailing Address - Fax:
Practice Address - Street 1:395 CADELEIGH CT
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30005-8925
Practice Address - Country:US
Practice Address - Phone:480-544-4491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD66881223G0001X
GADN0146671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice