Individual
MARK D. BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1420 E STONE DR, SUITE G, KINGSPORT, TN 37660-4165
(423) 247-6961
(423) 247-5552
Mailing address
1420 E STONE DR, SUITE G, KINGSPORT, TN 37660-4165
(423) 247-6961
(423) 247-5552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS3216
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0095926
BCBS TN
TN
01
—
241198
TRIGON
VA
Enumeration date
11/09/2006
Last updated
07/08/2007
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