Individual
DR. MICHAEL JOHN BUCZOLICH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3533 MCKINLEY AVE, SOUTH BEND, IN 46615-3134
(574) 289-7155
(574) 289-9755
Mailing address
3533 MCKINLEY AVE, SOUTH BEND, IN 46615-3134
(574) 289-7155
(574) 289-9755
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009618
IN
Other
Enumeration date
08/26/2006
Last updated
07/08/2007
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