Provider Demographics
NPI:1619751401
Name:ADAM H BUCKLER DDS
Entity Type:Organization
Organization Name:ADAM H BUCKLER DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:BUCKLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-775-6600
Mailing Address - Street 1:64 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-2420
Mailing Address - Country:US
Mailing Address - Phone:740-775-6600
Mailing Address - Fax:740-851-5460
Practice Address - Street 1:64 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2420
Practice Address - Country:US
Practice Address - Phone:740-775-6600
Practice Address - Fax:740-851-5460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH14666128Medicaid