MEDICARE: DR. DENNIS JL BUCHMAN D.M.D.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN7667	FL

General Provider Information

NPI Number	:	1932239779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS JL BUCHMAN D.M.D.

Provider Business Mailing Address
First Line	:	1205 W BAKER ST
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-4309
Country	:	US
Telephone Number	:	813-659-4929
Fax Number	:	813-659-4941

Provider Business Practice Location Address
First Line	:	1205 W BAKER STREET
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-4309
Country	:	US
Telephone Number	:	813-659-4929
Fax Number	:	813-659-4941

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/08/2007

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