Organization
BRADLEY BUCHWALD DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY JASON BUCHWALD DMD (OWNER)
(972) 377-5940
Entity
Organization
Contact information
Practice address
6549 COIT RD, STE 124, FRISCO, TX 75035
(972) 377-5940
Mailing address
6549 COIT RD, STE 124, FRISCO, TX 75035
(972) 377-5940
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639426521
NPPES
TX
Enumeration date
11/05/2018
Last updated
11/05/2018
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