MEDICARE: BUDDE & BUEKER D.D.S., PARTNERSHIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1417275439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUDDE & BUEKER D.D.S., PARTNERSHIP

Provider Business Mailing Address
First Line	:	PO BOX 180
Second Line	:
City	:	KILL DEVIL HILLS
State	:	NC
Zip	:	27948-0180
Country	:	US
Telephone Number	:	252-441-5811
Fax Number	:

Provider Business Practice Location Address
First Line	:	3118 N CROATAN HWY
Second Line	:
City	:	KILL DEVIL HILLS
State	:	NC
Zip	:	27948-9254
Country	:	US
Telephone Number	:	252-441-5811
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. KEN FRITZ BUDDE
Credential	:	D.D.S.
Telephone Number	:	252-441-5811

Provider Enumeration Date	:	05/14/2010
Last Update Date	:	05/14/2010

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