Organization
SOUTHWEST CENTER FOR ORAL, FACIAL AND DENTAL IMPLANT SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JEFFERSON BUCH MD, DDS (OWNER)
(623) 792-5794
Entity
Organization
Contact information
Practice address
6677 W THUNDERBIRD RD, SUITE H120, GLENDALE, AZ 85306-3709
(623) 792-5794
(623) 792-5809
Mailing address
6677 W THUNDERBIRD RD, SUITE H120, GLENDALE, AZ 85306-3709
(623) 792-5794
(623) 792-5809
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D3178
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D8077
AZ
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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