Healthcare Provider Details

I. General information

NPI: 1467567974
Provider Name (Legal Business Name): ROBERT J. BUCH D.D.S., M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6677 W THUNDERBIRD RD STE H120
GLENDALE AZ
85306-3726
US

IV. Provider business mailing address

6677 W THUNDERBIRD RD STE H120
GLENDALE AZ
85306-3726
US

V. Phone/Fax

Practice location:
  • Phone: 623-792-5794
  • Fax: 623-792-5809
Mailing address:
  • Phone: 623-792-5794
  • Fax: 623-792-5809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberD8077
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: