Provider Demographics
NPI:1770125502
Name:BUCHMAN DENTAL
Entity type:Organization
Organization Name:BUCHMAN DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-590-4043
Mailing Address - Street 1:10319 W MARKHAM ST STE 600
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-4559
Mailing Address - Country:US
Mailing Address - Phone:501-227-6200
Mailing Address - Fax:501-224-2328
Practice Address - Street 1:10319 W MARKHAM ST STE 600
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-4559
Practice Address - Country:US
Practice Address - Phone:501-227-6200
Practice Address - Fax:501-224-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1223G0001XMedicaid