Provider Demographics
NPI:1568994051
Name:BUCK & JOHNSTON ORTHODONTICS PLLC
Entity Type:Organization
Organization Name:BUCK & JOHNSTON ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MBR
Authorized Official - Phone:281-421-1100
Mailing Address - Street 1:7711 GARTH RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-8784
Mailing Address - Country:US
Mailing Address - Phone:281-421-1100
Mailing Address - Fax:281-421-4970
Practice Address - Street 1:7711 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-8784
Practice Address - Country:US
Practice Address - Phone:281-421-1100
Practice Address - Fax:281-421-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122681223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty