Provider Demographics
NPI:1730466749
Name:BUXBAUM, DANE C (ND)
Entity Type:Individual
Prefix:DR
First Name:DANE
Middle Name:C
Last Name:BUXBAUM
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 W RAY RD APT 2084
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4088
Mailing Address - Country:US
Mailing Address - Phone:480-648-0221
Mailing Address - Fax:480-648-0201
Practice Address - Street 1:1825 W RAY RD APT 2084
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4088
Practice Address - Country:US
Practice Address - Phone:480-648-0221
Practice Address - Fax:480-648-0201
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11-1268175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath