Provider Demographics
NPI:1144272832
Name:BUCHMANN, CRAIG E (DDS)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:E
Last Name:BUCHMANN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 W INTERSTATE HWY 635
Mailing Address - Street 2:SUITE 445
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3811
Mailing Address - Country:US
Mailing Address - Phone:972-401-8301
Mailing Address - Fax:972-444-8265
Practice Address - Street 1:1139 KELLER PKWY
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3614
Practice Address - Country:US
Practice Address - Phone:817-379-1654
Practice Address - Fax:817-379-1643
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX156991223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8228M1Medicare ID - Type Unspecified
TXU89974Medicare UPIN
TX8228M1Medicare PIN