Healthcare Provider Details

I. General information

NPI: 1720092422
Provider Name (Legal Business Name): RONALD LOIUS BUCARI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 NORTHWESTERN DR
BLOOMFIELD CT
06002-3465
US

IV. Provider business mailing address

61 BEE MOUNTAIN RD
NEW HARTFORD CT
06057-3500
US

V. Phone/Fax

Practice location:
  • Phone: 860-243-8989
  • Fax: 860-243-2929
Mailing address:
  • Phone: 860-489-3328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number8383
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: