Provider Demographics
NPI:1134442098
Name:BUCHSIEB, WALTER C (DDS)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:C
Last Name:BUCHSIEB
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 1:1212 HARRISON POND DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9553
Mailing Address - Country:US
Mailing Address - Phone:614-939-9333
Mailing Address - Fax:
Practice Address - Street 1:1212 HARRISON POND DR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-9553
Practice Address - Country:US
Practice Address - Phone:614-939-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH105491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics