MEDICARE: WILLIAM BUNCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1683	AZ

General Provider Information

NPI Number	:	1134291065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM BUNCH

Provider Business Mailing Address
First Line	:	PO BOX 290
Second Line	:
City	:	ORACLE
State	:	AZ
Zip	:	85623-0290
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 EAST AM AVE
Second Line	:
City	:	ORACLE
State	:	AZ
Zip	:	85623
Country	:	US
Telephone Number	:	520-896-9334
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	WILLIAM M BUNCH
Credential	:	DMD, PC
Telephone Number	:	520-896-9334

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	08/22/2020

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