Provider Demographics
NPI:1518316553
Name:BUCHERT, RACHEL (DDS)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BUCHERT
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 1:5417 N HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-5215
Mailing Address - Country:US
Mailing Address - Phone:612-770-1185
Mailing Address - Fax:
Practice Address - Street 1:220 SE 21ST ST
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-4268
Practice Address - Country:US
Practice Address - Phone:402-554-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7326122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist