Provider Demographics
NPI:1306554662
Name:AARON E. BUYACK, D.M.D., PLLC
Entity type:Organization
Organization Name:AARON E. BUYACK, D.M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:BUYACK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-620-9277
Mailing Address - Street 1:200 ELM ST STE 2
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6551
Mailing Address - Country:US
Mailing Address - Phone:413-499-4850
Mailing Address - Fax:
Practice Address - Street 1:200 ELM ST STE 2
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6551
Practice Address - Country:US
Practice Address - Phone:413-499-4850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty