Provider Demographics
NPI:1295410488
Name:BUCCINO, JULIANA HATHAWAY (DMD)
Entity type:Individual
Prefix:DR
First Name:JULIANA
Middle Name:HATHAWAY
Last Name:BUCCINO
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 ROBESON ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5497
Mailing Address - Country:US
Mailing Address - Phone:508-676-0111
Mailing Address - Fax:
Practice Address - Street 1:497 ROBESON ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5497
Practice Address - Country:US
Practice Address - Phone:508-676-0111
Practice Address - Fax:508-678-6764
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859938122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program