Provider Demographics
NPI:1699814566
Name:W CHARLES BUCHSIEB II DDS INC
Entity Type:Organization
Organization Name:W CHARLES BUCHSIEB II DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BUCHSIEB
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-428-8002
Mailing Address - Street 1:1386 CHERRY BOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6771
Mailing Address - Country:US
Mailing Address - Phone:614-428-8002
Mailing Address - Fax:614-428-8048
Practice Address - Street 1:1386 CHERRY BOTTOM RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6771
Practice Address - Country:US
Practice Address - Phone:614-428-8002
Practice Address - Fax:614-428-8048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH177091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty