Provider Demographics
NPI:1619471356
Name:BUFORD, ALLISON W (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:W
Last Name:BUFORD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:R
Other - Last Name:WEXLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2325 DOUGHERTY FERRY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3356
Mailing Address - Country:US
Mailing Address - Phone:314-394-1914
Mailing Address - Fax:
Practice Address - Street 1:2325 DOUGHERTY FERRY RD STE 200
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3356
Practice Address - Country:US
Practice Address - Phone:314-394-1914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20180430861223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry