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General NPI Number Information
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NPI Number | 1003683418
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Entity Type | Organization
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Legal Business Name | DR. NICOLE BUNDY-SOLAK PLLC
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 4025 E HILL RD
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City | GRAND BLANC
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State | MI
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Zip | 48439-7942
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Country | US
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Telephone | 810-695-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 5313 BRIARCREST DR
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City | FLINT
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State | MI
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Zip | 48532-2206
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICOLE CHRISTINE BUNDY-SOLAK
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Credential | DMD
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Telephone | 810-247-1314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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