Individual
ANTHONY BUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
653 W 8TH ST, FACULTY CLINIC 3RD FL, JACKSONVILLE, FL 32209-6511
(904) 244-3689
(904) 244-3870
Mailing address
653 W 8TH ST, FACULTY CLINIC 3RD FL, JACKSONVILLE, FL 32209-6511
(904) 244-3689
(904) 244-3870
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DRP838
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
ME128004
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DRP838
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
ME128004
FL
Other
Enumeration date
05/18/2010
Last updated
03/23/2023
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