Provider Demographics
NPI:1285617357
Name:BUIST, JOHN A (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:BUIST
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:126 INVERNESS DRIVE EAST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112
Mailing Address - Country:US
Mailing Address - Phone:720-875-1130
Mailing Address - Fax:720-875-1166
Practice Address - Street 1:125 INVERNESS DRIVE EAST
Practice Address - Street 2:SUITE 360
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112
Practice Address - Country:US
Practice Address - Phone:720-875-1130
Practice Address - Fax:720-875-1166
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO5157122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist