Provider Demographics
NPI:1417351693
Name:CLAUDIO BUONFIGLIO, D.M.D., P.A.
Entity Type:Organization
Organization Name:CLAUDIO BUONFIGLIO, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BUONFIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-767-0633
Mailing Address - Street 1:703 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5705
Mailing Address - Country:US
Mailing Address - Phone:407-767-0633
Mailing Address - Fax:407-767-6554
Practice Address - Street 1:703 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5705
Practice Address - Country:US
Practice Address - Phone:407-767-0633
Practice Address - Fax:407-767-6554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-16
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16527261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental