Provider Demographics
NPI:1073834008
Name:BUSCHEL, BARRY L (DDS)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:L
Last Name:BUSCHEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-1391
Mailing Address - Country:US
Mailing Address - Phone:817-920-0882
Mailing Address - Fax:817-920-0709
Practice Address - Street 1:1818 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-1391
Practice Address - Country:US
Practice Address - Phone:817-920-0882
Practice Address - Fax:817-920-0709
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16953122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist