Provider Demographics
NPI:1366538779
Name:BUCK, JAMES R (JAMES BUCK DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:BUCK
Suffix:
Gender:M
Credentials:JAMES BUCK DDS
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:BUCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JAMES BUCK DDS
Mailing Address - Street 1:1055 17TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-2647
Mailing Address - Country:US
Mailing Address - Phone:303-776-1335
Mailing Address - Fax:303-776-7516
Practice Address - Street 1:1055 17TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-2647
Practice Address - Country:US
Practice Address - Phone:303-776-1335
Practice Address - Fax:303-776-7516
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1041631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice