Provider Demographics
NPI:1518980929
Name:BUZZARD, DEBORAH ANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANNE
Last Name:BUZZARD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 LIME KILN LN
Mailing Address - Street 2:SUITE E
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-3429
Mailing Address - Country:US
Mailing Address - Phone:502-426-6089
Mailing Address - Fax:502-339-0312
Practice Address - Street 1:2415 LIME KILN LN
Practice Address - Street 2:SUITE E
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-3429
Practice Address - Country:US
Practice Address - Phone:502-426-6089
Practice Address - Fax:502-339-0312
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY58551223G0001X
KY59181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice