Individual
DR. MARISSA RENEE BUNGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
644 W OSHKOSH ST, RIPON, WI 54971-1001
(920) 748-6122
Mailing address
W13233 PENNY LN, RIPON, WI 54971-9586
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001194
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2023
Last updated
06/21/2023
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