Individual
DR. JONATHAN BRUCE JUNKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
95 US HIGHWAY 51 BYP W, DYERSBURG, TN 38024-1935
(731) 286-1271
(731) 286-0019
Mailing address
540 E STATE HIGHWAY 239, BLYTHEVILLE, AR 72315-8808
(910) 750-2002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2987
AR
1223P0221X
Pediatric Dentistry
2987
AR
1223P0221X
Pediatric Dentistry
Primary
9318
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62-1399728
TAX ID
TN
Enumeration date
03/02/2006
Last updated
11/13/2013
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