Provider Demographics
NPI:1912098369
Name:BUCKSELL, MICHAEL N (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:N
Last Name:BUCKSELL
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 1:28095 THREE NOTCH RD
Mailing Address - Street 2:STE 1A
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20659-3373
Mailing Address - Country:US
Mailing Address - Phone:301-884-8133
Mailing Address - Fax:301-884-0513
Practice Address - Street 1:28095 THREE NOTCH RD
Practice Address - Street 2:STE 1A
Practice Address - City:MECHANICSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20659-3373
Practice Address - Country:US
Practice Address - Phone:301-884-8133
Practice Address - Fax:301-884-0513
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7590122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist