Provider Demographics
NPI:1043429400
Name:BUCY, BILL L (DDS)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:L
Last Name:BUCY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:WILLIA
Other - Middle Name:L
Other - Last Name:BUCY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2115 14TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NE
Mailing Address - Zip Code:68305-1760
Mailing Address - Country:US
Mailing Address - Phone:402-274-3709
Mailing Address - Fax:
Practice Address - Street 1:2115 14TH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NE
Practice Address - Zip Code:68305-1760
Practice Address - Country:US
Practice Address - Phone:402-274-3709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE45201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE83034611500Medicaid
NE7801OtherBCBS IDENTIFIER