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NPI Code Detail

MEDICARE: DR. JUAN MANUEL BUGUENO DDS

MEDICARE: DR. JUAN MANUEL BUGUENO DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223S0112XOral and Maxillofacial Surgery (Dentist)DEN5112ME
2122300000XDentist21674TX
31223X2210XOrofacial Pain DentistryDEN5112ME
4122300000XDentistDEN5112ME

General Provider Information

NPI Number : 1730150525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUAN MANUEL BUGUENO DDS
Provider Business Mailing Address
First Line : PO BOX 9465
Second Line :
City : MORGANTOWN
State : WV
Zip : 26506-9465
Country : US
Telephone Number : 304-293-4703
Fax Number : 304-293-7649
Provider Business Practice Location Address
First Line : 1 COLLEGE ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2617
Country : US
Telephone Number : 207-212-4739
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 07/09/2024

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