Organization
BUCKEYE DENTAL AND DENTURE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH BUSCH D.D.S. (OWNER)
(937) 439-0834
Entity
Organization
Contact information
Practice address
2198 HEWITT AVE, KETTERING, OH 45440-4242
(937) 439-0834
(937) 439-0880
Mailing address
2198 HEWITT AVE, KETTERING, OH 45440-4242
(937) 439-0880
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16235
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0409687
—
OH
Enumeration date
05/10/2007
Last updated
10/31/2007
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