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General NPI Number Information
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NPI Number | 1922092832
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Entity Type | Organization
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Legal Business Name | R.M. BUNTIN, DDS, PC
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 2925 PLAYER ST
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City | BRUNSWICK
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State | GA
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Zip | 31520-4950
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Country | US
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Telephone | 912-265-2675
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Fax | 912-265-2886
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Provider Business Mailing Address
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Address Line | 2925 PLAYER ST
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City | BRUNSWICK
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State | GA
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Zip | 31520-4950
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Country | US
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Telephone | 912-265-2675
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Fax | 912-265-2886
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT MCCOLLUM BUNTIN
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Credential | DDS
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Telephone | 912-265-2675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7287
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License Number State | GA
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