Provider Demographics
NPI:1356447767
Name:BUCK, DAVID E (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:BUCK
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 1:2018 POLLACK AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-4348
Mailing Address - Country:US
Mailing Address - Phone:812-476-9391
Mailing Address - Fax:812-476-0224
Practice Address - Street 1:2018 POLLACK AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-4348
Practice Address - Country:US
Practice Address - Phone:812-476-9391
Practice Address - Fax:812-476-0224
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008250A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist