Provider Demographics
NPI:1932296720
Name:BUCHER, LARRY DUANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:DUANE
Last Name:BUCHER
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 1:1091 LANNER ST. N.W.
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720
Mailing Address - Country:US
Mailing Address - Phone:330-705-9829
Mailing Address - Fax:
Practice Address - Street 1:204 S BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-9405
Practice Address - Country:US
Practice Address - Phone:330-365-1781
Practice Address - Fax:234-801-4647
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0191721223G0001X
OH300191721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0257471Medicaid