Healthcare Provider Details

I. General information

NPI: 1477583136
Provider Name (Legal Business Name): JAMES GARRETT BUNTON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4635 WYANDOTTE SUITE 200
KANSAS CITY MO
64112
US

IV. Provider business mailing address

4635 WYANDOTTE SUITE 200
KANSAS CITY MO
64112
US

V. Phone/Fax

Practice location:
  • Phone: 816-753-2664
  • Fax: 816-753-4240
Mailing address:
  • Phone: 816-753-2664
  • Fax: 816-753-4240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number012255
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: