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NPI Code Detail

MEDICARE: BUCKLIN FAMILY DENTISTRY

MEDICARE: BUCKLIN FAMILY 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
11223G0001XGeneral Practice Dentistry2901019767MI

General Provider Information

NPI Number : 1982041901
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUCKLIN FAMILY DENTISTRY
Provider Business Mailing Address
First Line : 32 DIVISION ST
Second Line :
City : COLDWATER
State : MI
Zip : 49036-1966
Country : US
Telephone Number : 517-278-7436
Fax Number :
Provider Business Practice Location Address
First Line : 32 DIVISION ST
Second Line :
City : COLDWATER
State : MI
Zip : 49036-1966
Country : US
Telephone Number : 517-278-7436
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. AMANDA MARIE BUCKLIN
Credential : DDS
Telephone Number : 517-745-8222
Provider Enumeration Date : 05/30/2013
Last Update Date : 05/30/2013

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Directions to “BUCKLIN FAMILY DENTISTRY ” Practice Location

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