Individual
DR. LARRY ROSS BUNTYN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1203 GOVERNMENT ST, OCEAN SPRINGS, MS 39564-3819
(228) 875-3343
(228) 872-9794
Mailing address
1203 GOVERNMENT ST, OCEAN SPRINGS, MS 39564-3819
(228) 875-3343
(228) 872-9794
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3086-99
MS
1223G0001X
General Practice Dentistry
5610
LA
Other
Enumeration date
10/03/2006
Last updated
05/18/2009
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