Provider Demographics
NPI:1659481554
Name:BUFALINI, MARK EDWARD (DMD MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDWARD
Last Name:BUFALINI
Suffix:
Gender:M
Credentials:DMD MD
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Mailing Address - Street 1:1305 PHYSICIANS DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7352
Mailing Address - Country:US
Mailing Address - Phone:910-762-2618
Mailing Address - Fax:910-763-5173
Practice Address - Street 1:1305 PHYSICIANS DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7352
Practice Address - Country:US
Practice Address - Phone:910-762-2618
Practice Address - Fax:910-763-5173
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-003641223S0112X, 204E00000X, 208600000X
PADS0355761223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery