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Organization
WAYNE PUNDT DDS
Active
Organization
WAYNE PUNDT DDS
Active
Other names
Pundt Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE E. PUNDT DDS (OWNER)
(254) 634-0234
Entity
Organization
Contact information
Practice address
421 N 38TH ST, KILLEEN, TX 76543-4153
(254) 634-0234
Mailing address
421 N 38TH ST, KILLEEN, TX 76543-4153
(254) 634-0234
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10225
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
814-402
UNITED CONCORDIA PROVIDER ID
TX
01
—
G60415-01
DELTA DENTAL CHIPS PROGRAM
TX
Enumeration date
05/19/2008
Last updated
05/19/2008
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