MEDICARE: DR. EMILY LOUISE SAUNDERS BUNDY D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DEN00010227	CO
2	122300000X	Dentist	DD3122	NM

General Provider Information

NPI Number	:	1053561043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY LOUISE SAUNDERS BUNDY D.D.S.

Provider Business Mailing Address
First Line	:	12600 W COLFAX AVE
Second Line	:	STE B160
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-3733
Country	:	US
Telephone Number	:	303-237-0307
Fax Number	:

Provider Business Practice Location Address
First Line	:	12600 W COLFAX AVE
Second Line	:	STE B160
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-3733
Country	:	US
Telephone Number	:	303-237-0307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2008
Last Update Date	:	06/07/2016

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