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General NPI Number Information
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NPI Number | 1932331485
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Entity Type | Organization
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Legal Business Name | BUCKLEY AND BUCKLEY FAMILY DENTISTRY
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 604 E NASHVILLE AVE
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City | ATMORE
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State | AL
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Zip | 36502
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Country | US
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Telephone | 251-368-4210
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 SPRING HILL AVE
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City | MOBILE
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State | AL
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Zip | 36608
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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 | OWNER/DENTIST
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Name | DR. DANIEL BUCKLEY
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Credential |
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Telephone | 251-368-4210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5231
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License Number State | AL
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