Provider Demographics
NPI:1467720979
Name:BUCCI, MARK D (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:BUCCI
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:11828 FISHING POINT DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4500
Mailing Address - Country:US
Mailing Address - Phone:757-595-0496
Mailing Address - Fax:757-595-0495
Practice Address - Street 1:11828 FISHING POINT DR
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4500
Practice Address - Country:US
Practice Address - Phone:757-595-0496
Practice Address - Fax:757-595-0495
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA04014134151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics