Provider Demographics
NPI:1770043713
Name:RANDY E BUCHMILLER DDS INC
Entity Type:Organization
Organization Name:RANDY E BUCHMILLER DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BUCHMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:951-676-0296
Mailing Address - Street 1:29645 RANCHO CALIFORNIA RD STE 121
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5285
Mailing Address - Country:US
Mailing Address - Phone:951-676-0296
Mailing Address - Fax:951-676-9563
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD STE 121
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5285
Practice Address - Country:US
Practice Address - Phone:951-676-0296
Practice Address - Fax:951-676-9563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty