Provider Demographics
NPI:1306093562
Name:BUSCAGLIA, CHRIS A (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:A
Last Name:BUSCAGLIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77-530 ENFIELD LANE
Mailing Address - Street 2:STE:202
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211
Mailing Address - Country:US
Mailing Address - Phone:760-360-6362
Mailing Address - Fax:
Practice Address - Street 1:77530 ENFIELD LN STE 202
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-7261
Practice Address - Country:US
Practice Address - Phone:760-360-6362
Practice Address - Fax:760-360-0237
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA368941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice