Healthcare Provider Details

I. General information

NPI: 1306259965
Provider Name (Legal Business Name): ARIANNE GALINO BUNIAG DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS ARIANNE F GALINO

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MDG / RAF LAKENHEATH UNIT 5115
APO AE
09461
US

IV. Provider business mailing address

48 MDG / RAF LAKENHEATH UNIT 5115
APO AE
09461
US

V. Phone/Fax

Practice location:
  • Phone: 314-226-9371
  • Fax:
Mailing address:
  • Phone: 314-226-9371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number22DI02861600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS043339
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: