Gushin, Lisa

Gushin, Lisa is an individual health care provider with primary practice located at 203 Owen Dr , Fayetteville NC 28304-3409. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Gushin, Lisa can be contacted via phone (910) 484-1771.

Contact Information

Primary practice address
203 Owen Dr Fayetteville NC 28304-3409
Phone: (910) 484-1771
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6908 North Carolina

Profile Details

NPI number 1962575977
LBN Legal business name Gushin, Lisa
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated Jan 24th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962575977 NPPES
North Carolina Other 586286 UNITED CONCORDIA
North Carolina Other 9010F UNITED CONCORDIA
North Carolina MEDICAID 899010F UNITED CONCORDIA

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