Provider Demographics
NPI:1891796884
Name:BUELL, MARIE ALEJANDRINO (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:ALEJANDRINO
Last Name:BUELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2861 N VENTURA RD # 102
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2213
Mailing Address - Country:US
Mailing Address - Phone:805-981-3868
Mailing Address - Fax:805-981-3869
Practice Address - Street 1:2861 N VENTURA RD # 102
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2213
Practice Address - Country:US
Practice Address - Phone:805-981-3868
Practice Address - Fax:805-981-3869
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2016-12-09
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
CA441371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice