Organization
ELISHA W BUCKLEY DDS PC
Active
Other names
Buckley Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELISHA BUCKLEY DDS (OWNER)
(678) 524-7364
Entity
Organization
Contact information
Practice address
540 E CROSSVILLE RD STE 200, ROSWELL, GA 30075-7661
(678) 524-7364
Mailing address
4807 WIGLEY RD NE, MARIETTA, GA 30066-1503
(678) 524-7364
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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