Provider Demographics
NPI:1245332279
Name:BUCK, PAUL EZEKIEL SR (DMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EZEKIEL
Last Name:BUCK
Suffix:SR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8700 BAYBERRY PLACE
Mailing Address - Street 2:PAUL E BUCK DMD
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242
Mailing Address - Country:US
Mailing Address - Phone:502-426-1600
Mailing Address - Fax:502-426-1600
Practice Address - Street 1:8700 BAYBERRY PLACE
Practice Address - Street 2:PAUL E BUCK DMD
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40242
Practice Address - Country:US
Practice Address - Phone:502-426-1600
Practice Address - Fax:502-426-1600
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice