Provider Demographics
NPI:1952578155
Name:BUONO, JOSEPH MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:BUONO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MEDICAL PLZ
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2193
Mailing Address - Country:US
Mailing Address - Phone:516-759-7505
Mailing Address - Fax:516-759-7542
Practice Address - Street 1:10 MEDICAL PLZ
Practice Address - Street 2:SUITE 210
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2193
Practice Address - Country:US
Practice Address - Phone:516-759-7505
Practice Address - Fax:516-759-7542
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0415671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice