Provider Demographics
NPI:1992464770
Name:CHRISTOPHER BUEGE DDS DBA GRANDVIEW DENTAL
Entity type:Organization
Organization Name:CHRISTOPHER BUEGE DDS DBA GRANDVIEW DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BUEGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-441-6146
Mailing Address - Street 1:900 CREST VIEW DR STE 240
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-9517
Mailing Address - Country:US
Mailing Address - Phone:715-381-5556
Mailing Address - Fax:
Practice Address - Street 1:900 CREST VIEW DR STE 240
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-9517
Practice Address - Country:US
Practice Address - Phone:715-381-5556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental