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General NPI Number Information
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NPI Number | 1265743934
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Entity Type | Organization
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Legal Business Name | DAVID M. BUNKALL, D.D.S., M.S., P.A.
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Dates
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Enumeration Date | 06/28/2010
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Last Update Date | 06/28/2010
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Provider Practice Location Address
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Address Line | 705 1ST AVE STE B
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City | DODGE CITY
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State | KS
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Zip | 67801-4437
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Country | US
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Telephone | 620-227-2234
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Fax | 620-227-8084
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Provider Business Mailing Address
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Address Line | 705 1ST AVE STE B
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City | DODGE CITY
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State | KS
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Zip | 67801-4437
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Country | US
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Telephone | 620-227-2234
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Fax | 620-227-8084
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID MICHAEL BUNKALL
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Credential | D.D.S., M.S.
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Telephone | 620-227-2234
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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 | 60750
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License Number State | KS
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