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General NPI Number Information
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NPI Number | 1912708918
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Entity Type | Organization
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Legal Business Name | BUCHANAN DENTISTRY LLC
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 5465 SIMMONS ST STE 4
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-9001
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Country | US
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Telephone | 702-638-1005
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Fax |
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Provider Business Mailing Address
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Address Line | 6849 SIGRI ST
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City | LAS VEGAS
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State | NV
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Zip | 89166-7015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHARLES BUCHANAN
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Credential | DMD
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Telephone | 702-716-6077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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