Provider Demographics
NPI:1154581262
Name:BUXTON, JEFFREY L (DMD, PC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:BUXTON
Suffix:
Gender:M
Credentials:DMD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5872 SOUTH 900 EAST STE #252
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121
Mailing Address - Country:US
Mailing Address - Phone:801-278-3214
Mailing Address - Fax:801-449-9280
Practice Address - Street 1:5872 SOUTH 900 EAST STE #252
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121
Practice Address - Country:US
Practice Address - Phone:801-278-3214
Practice Address - Fax:801-449-9280
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT70236571223G0001X
UT7023657-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice