Provider Demographics
NPI:1821190455
Name:BUGDEN, DAVID M (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:BUGDEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11259 LOCKWOOD DR STE B
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4569
Mailing Address - Country:US
Mailing Address - Phone:301-681-4241
Mailing Address - Fax:301-681-3079
Practice Address - Street 1:11259 LOCKWOOD DR STE B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4569
Practice Address - Country:US
Practice Address - Phone:301-681-4241
Practice Address - Fax:301-681-3079
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD70031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521470452OtherTIN