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NPI 1699814566

NPI 1699814566 : W CHARLES BUCHSIEB II DDS INC : GAHANNA, OH

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General NPI Number Information
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    NPI Number           |    1699814566
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    Entity Type          |    Organization 
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    Legal Business Name  |    W CHARLES BUCHSIEB II DDS INC 
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Dates
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    Enumeration Date     |    02/06/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    1386 CHERRY BOTTOM RD 
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    City                 |    GAHANNA
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    State                |    OH
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    Zip                  |    43230-6771
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    Country              |    US
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    Telephone            |    614-428-8002
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    Fax                  |    614-428-8048
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Provider Business Mailing Address
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    Address Line         |    1386 CHERRY BOTTOM RD 
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    City                 |    GAHANNA
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    State                |    OH
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    Zip                  |    43230-6771
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    Country              |    US
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    Telephone            |    614-428-8002
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    Fax                  |    614-428-8048
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. WALTER CHARLES BUCHSIEB II
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    Credential           |    DDS
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    Telephone            |    614-428-8002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    17709
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    License Number State |    OH
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