Provider Demographics
NPI:1285894956
Name:BUECHELE, MANFRED FRANZ (DMD)
Entity type:Individual
Prefix:DR
First Name:MANFRED
Middle Name:FRANZ
Last Name:BUECHELE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12344 ROPER BLVD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-4300
Mailing Address - Country:US
Mailing Address - Phone:352-242-1763
Mailing Address - Fax:
Practice Address - Street 1:12344 ROPER BLVD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-4300
Practice Address - Country:US
Practice Address - Phone:352-242-1763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL183201223G0001X
FLDN183201223G0001X
FLDN/8320122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice