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Individual

DR. PAUL MICHAEL THORSEN BUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.D.

Contact information

Practice address
550 COUNTY ROAD D W STE 12, NEW BRIGHTON, MN 55112-3517
(612) 788-9246
Mailing address
550 COUNTY ROAD D W STE 12, NEW BRIGHTON, MN 55112-3517
(612) 788-9246

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
D9768
OR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D9768
OR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DE60827554
WA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
D13762
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
PG173069
OR

Other

Enumeration date
04/26/2012
Last updated
10/11/2023
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