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Individual

DR. DERIC ROBERT BUDENDORF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 471-5950
(330) 471-5947
Mailing address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 471-5950
(330) 471-5947

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
30024164
OH
1223G0001X
General Practice Dentistry
Primary
RES.3313
OH

Other

Enumeration date
01/15/2014
Last updated
04/21/2014
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