Provider Demographics
NPI:1205005162
Name:BUCHALSKI, JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:BUCHALSKI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 JOURNAL SQ
Mailing Address - Street 2:SUITE 325
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-4009
Mailing Address - Country:US
Mailing Address - Phone:201-216-0011
Mailing Address - Fax:210-217-1070
Practice Address - Street 1:40 JOURNAL SQ
Practice Address - Street 2:SUITE 325
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-4009
Practice Address - Country:US
Practice Address - Phone:201-216-0011
Practice Address - Fax:210-217-1070
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4591003Medicaid