# BUNCH-PAYNE, ORAL AND MAXILLOFACIAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BUNCH-PAYNE ORAL AND MAXILLOFACIAL SURGERY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1699818872
- **Legal business name:** BUNCH-PAYNE ORAL AND MAXILLOFACIAL SURGERY
- **Authorized official:** DR. FRED L BUNCH D.D.S. (PARTNER)
- **Authorized official phone:** (209) 951-6387

## Contact information

- **Practice address:** 756 PORTER AVE, SUITE 400, STOCKTON, CA 95207-4232
- **Practice address phone:** (209) 951-6387
- **Practice address fax:** (209) 951-2824
- **Mailing address:** 756 PORTER AVE, SUITE 400, STOCKTON, CA 95207-4232
- **Mailing address phone:** (209) 951-6387
- **Mailing address fax:** (209) 951-2824

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 02/15/2007
- **Last updated:** 09/13/2010