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NPI Code Detail

MEDICARE: STEVEN T BUNN DDS

MEDICARE: STEVEN T BUNN DDS
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
1122300000XDentistO401006432VA

General Provider Information

NPI Number : 1922169432
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN T BUNN DDS
Provider Business Mailing Address
First Line : 205 S LOCUST ST APT 7
Second Line :
City : FLOYD
State : VA
Zip : 24091-2506
Country : US
Telephone Number : 703-861-1343
Fax Number :
Provider Business Practice Location Address
First Line : 4701 COX RD STE 285
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-6808
Country : US
Telephone Number : 615-995-1923
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 03/17/2018

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