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Organization
BUNCH-PAYNE, ORAL AND MAXILLOFACIAL SURGERY
Active
Organization
BUNCH-PAYNE, ORAL AND MAXILLOFACIAL SURGERY
Active
Parent organization
BUNCH-PAYNE ORAL AND MAXILLOFACIAL SURGERY
Organization subpart
Yes
Provider details
NPI number
Legal business name
BUNCH-PAYNE ORAL AND MAXILLOFACIAL SURGERY
Authorized official
DR. FRED L BUNCH D.D.S. (PARTNER)
(209) 951-6387
Entity
Organization
Contact information
Practice address
756 PORTER AVE, SUITE 400, STOCKTON, CA 95207-4232
(209) 951-6387
(209) 951-2824
Mailing address
756 PORTER AVE, SUITE 400, STOCKTON, CA 95207-4232
(209) 951-6387
(209) 951-2824
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/15/2007
Last updated
09/13/2010
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