Provider Demographics
NPI:1477939585
Name:AARON T. BUCHANAN, DDS PLLC
Entity Type:Organization
Organization Name:AARON T. BUCHANAN, DDS PLLC
Other - Org Name:BUCHANAN FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-304-7590
Mailing Address - Street 1:400 FAIRVIEW AVE
Mailing Address - Street 2:BLDG 1, STE 2
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601
Mailing Address - Country:US
Mailing Address - Phone:580-304-7590
Mailing Address - Fax:580-304-7593
Practice Address - Street 1:400 FAIRVIEW AVE
Practice Address - Street 2:BLDG 1, STE 2
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-1920
Practice Address - Country:US
Practice Address - Phone:580-304-7590
Practice Address - Fax:580-304-7593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6582122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty