Provider Demographics
NPI:1568207348
Name:BUSCHMANN, FRIDO (DMD)
Entity type:Individual
Prefix:DR
First Name:FRIDO
Middle Name:
Last Name:BUSCHMANN
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 1:350 N MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2707
Mailing Address - Country:US
Mailing Address - Phone:215-822-3838
Mailing Address - Fax:
Practice Address - Street 1:350 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2707
Practice Address - Country:US
Practice Address - Phone:215-822-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044732122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist