Healthcare Provider Details

I. General information

NPI: 1780604397
Provider Name (Legal Business Name): SEAN PATRICK BUEHLER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 MAIN ST
SUSANVILLE CA
96130-4426
US

IV. Provider business mailing address

P.O. BOX 1511
SUSANVILLE CA
96130
US

V. Phone/Fax

Practice location:
  • Phone: 530-257-3300
  • Fax: 530-257-3322
Mailing address:
  • Phone: 530-310-2158
  • Fax: 530-251-0577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number43906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: