MEDICARE: DR. CHRISTOPHER MICHAEL BULNES DMD

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	1223G0001X	General Practice Dentistry	DN15541	FL
2	1223G0001X	General Practice Dentistry	DN8669	FL

General Provider Information

NPI Number	:	1881713824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER MICHAEL BULNES DMD

Provider Business Mailing Address
First Line	:	3906 W NEPTUNE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-5829
Country	:	US
Telephone Number	:	813-259-9000
Fax Number	:	813-259-9923

Provider Business Practice Location Address
First Line	:	3906 W NEPTUNE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-5829
Country	:	US
Telephone Number	:	813-259-9000
Fax Number	:	813-259-9923

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/08/2007

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