Healthcare Provider Details

I. General information

NPI: 1780607069
Provider Name (Legal Business Name): DR. MICHAEL P. BUCHART JR.,DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2393 ALUMNI DR STE 102
LEXINGTON KY
40517-4285
US

IV. Provider business mailing address

2393 ALUMNI DR STE 102
LEXINGTON KY
40517-4285
US

V. Phone/Fax

Practice location:
  • Phone: 859-269-2757
  • Fax: 859-266-8222
Mailing address:
  • Phone: 859-269-2757
  • Fax: 859-266-8222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number7361
License Number StateKY

VIII. Authorized Official

Name: DR. MICHAEL P BUCHART JR.
Title or Position: PRESIDENT
Credential: DMD
Phone: 859-269-2757