Individual
GARY CLINTON BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2066 US HIGHWAY 45 BYP S, TRENTON, TN 38382-3507
(731) 855-1053
Mailing address
2066 US HIGHWAY 45 BYP S, TRENTON, TN 38382-3507
(731) 855-1053
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS8378
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1935988
UNITED CONCORDIA
TN
01
—
4120344
BLUE CROSS ID NUMBR
TN
Enumeration date
03/13/2007
Last updated
07/08/2007
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