MEDICARE: BUXTON DENTISTRY

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
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1841547312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUXTON DENTISTRY

Provider Business Mailing Address
First Line	:	1925 E 5600 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-1351
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 E 5600 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-1351
Country	:	US
Telephone Number	:	801-278-3214
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	JEFFREY L BUXTON
Credential	:
Telephone Number	:	801-278-3214

Provider Enumeration Date	:	08/14/2012
Last Update Date	:	08/14/2012

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Directions to “BUXTON DENTISTRY ” Practice Location

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