Provider Demographics
NPI:1417960105
Name:BUONO, BETH FRANCES (DDS)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:FRANCES
Last Name:BUONO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 RT 25A
Mailing Address - Street 2:SUITE 7
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733
Mailing Address - Country:US
Mailing Address - Phone:631-689-8888
Mailing Address - Fax:631-689-3700
Practice Address - Street 1:46 RT 25A
Practice Address - Street 2:SUITE 7
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733
Practice Address - Country:US
Practice Address - Phone:631-689-8888
Practice Address - Fax:631-689-3700
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY042014122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02043007Medicaid