Individual
DR. JUSTIN BUCHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
101 4TH AVE STE D, CRESTVIEW, FL 32539-2401
(850) 683-3544
Mailing address
54B MEIGS DR, SHALIMAR, FL 32579-2144
(678) 591-9692
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22127
FL
Other
Enumeration date
07/22/2016
Last updated
02/02/2017
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