Provider Demographics
NPI:1730639766
Name:BUCHWALD, MAXEY STANTON JR (DDS)
Entity type:Individual
Prefix:DR
First Name:MAXEY
Middle Name:STANTON
Last Name:BUCHWALD
Suffix:JR
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 1:300 N COIT RD STE 245
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-6261
Mailing Address - Country:US
Mailing Address - Phone:972-644-3280
Mailing Address - Fax:972-671-7925
Practice Address - Street 1:300 N COIT RD STE 245
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-6261
Practice Address - Country:US
Practice Address - Phone:972-644-3280
Practice Address - Fax:972-671-7925
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice