Individual
SUCHUNYA BUMRUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 SHADOW LN, LAS VEGAS, NV 89106-4124
(702) 774-2545
Mailing address
1710 E PINE ST, CENTRAL POINT, OR 97502-2811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12386
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2023
Last updated
07/29/2026
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