Individual
PHILLIP BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
525 E SPRINGFIELD RD, SAINT CLAIR, MO 63077-1735
(636) 629-1103
Mailing address
1008 TAMARISK DR, LEAVENWORTH, KS 66048-5594
(314) 566-9072
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2014016767
MO
Other
Enumeration date
07/28/2014
Last updated
03/22/2019
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