National Provider Identifier
Myron R Bucholtz, D.M.D.
Myron R Bucholtz, D.M.D. is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Waverly, NY and a listed phone number of (607) 565-4374.
Profile Overview
- NPI
- 1720077183
- Provider Type
- Individual
- Primary Specialty
- General Practice Dentistry
- Enumeration Date
- October 18, 2005
- Last Updated
- July 08, 2007
Practice Location
- 463 Fulton St
- Waverly, NY 14892-1312
Phone: (607) 565-4374
Specialties
- General Practice Dentistry (1223G0001X)
Full Record
- NPI
- 1720077183
- Entity Type
- Individual
- Last Name
- Bucholtz
- First Name
- Myron
- Middle Name
- R
- Name Prefix
- Dr.
- Credential
- D.M.D.
- Mailing Street Address
- 463 Fulton St
- Mailing City
- Waverly
- Mailing State
- NY
- Mailing ZIP Code
- 14892-1312
- Mailing Country
- US
- Mailing Phone
- (607) 565-4374
- Mailing Fax
- (607) 565-7438
- Practice Street Address
- 463 Fulton St
- Practice City
- Waverly
- Practice State
- NY
- Practice ZIP Code
- 14892-1312
- Practice Country
- US
- Practice Phone
- (607) 565-4374
- Practice Fax
- (607) 565-7438
- Enumeration Date
- October 18, 2005
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- X
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- General Practice Dentistry (1223G0001X)