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General NPI Number Information
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NPI Number | 1376136705
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Entity Type | Organization
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Legal Business Name | DR. KIMBERLY A. BUCKNER, P.L.C.
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 38 J F GREEN ST
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City | SANDY HOOK
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State | KY
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Zip | 41171-7134
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Country | US
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Telephone | 606-738-5545
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Fax | 606-738-5405
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Provider Business Mailing Address
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Address Line | PO BOX 85
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City | SANDY HOOK
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State | KY
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Zip | 41171-0085
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Country | US
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Telephone | 606-738-5545
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Fax | 606-738-5405
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Authorized Official
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Title or Position | OWNER
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Name | DR. KIMBERLY ANNE BUCKNER
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Credential | DMD
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Telephone | 606-738-5545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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