Provider Demographics
NPI:1740253830
Name:BUZIN, RICHARD CLARKE (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CLARKE
Last Name:BUZIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 MAMARONECK AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1662
Mailing Address - Country:US
Mailing Address - Phone:914-698-5228
Mailing Address - Fax:914-698-4861
Practice Address - Street 1:933 MAMARONECK AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1662
Practice Address - Country:US
Practice Address - Phone:914-698-5228
Practice Address - Fax:914-698-4861
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice