Provider Demographics
NPI:1841412814
Name:BUCHANAN, RICHARD STUART (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:STUART
Last Name:BUCHANAN
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 1:201 N, BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SPENCERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45887-1290
Mailing Address - Country:US
Mailing Address - Phone:419-647-4972
Mailing Address - Fax:419-647-6795
Practice Address - Street 1:201 N, BROADWAY
Practice Address - Street 2:
Practice Address - City:SPENCERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45887-1290
Practice Address - Country:US
Practice Address - Phone:419-647-4972
Practice Address - Fax:419-647-6795
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH119661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice