Organization Name: | MARK J. BUCHWALDER D.D.S., L.L.C. |
NPI Number: | 1154600013 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK J BUCHWALDER (DOCTOR) |
Mailing Address: | 1237 N Monroe Dr Suite 103 Xenia |
State: | OH US |
Postal Code: | 453856609 |
Phone Number: | 9373762441 |
Fax Number: | |
NPI Enumeration Date: | 08/10/2011 |
NPI Last Update Date: | 08/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | OH30018199 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |