Individual provider · NPI-1

Dr. Luke Russell Buck, DDS

Dentist, General Practice · Shawnee, OK

NPI number1417846106
StatusActive
Last updated in NPPESJun 30, 2025

Details

NPI
1417846106
Entity type
Individual (NPI-1)
Name
Dr. Luke Russell Buck
Credential
DDS
Sex
Male
Sole proprietor
No
Enumeration date
Jun 30, 2025
Certification date
Jun 8, 2025
Last updated
Jun 30, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice8021OKYes

Practice location

2307 Gordon Cooper Dr
Shawnee, OK 74801-9007

Phone 405-695-6004

Mailing address

980454 S Hwy 18
Chandler, OK 74834

Phone 405-831-8006

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