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Individual

DR. JOHN WATSON BUNTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
312 MISSOURI ST, WEST MEMPHIS, AR 72301
(870) 735-1673
(870) 735-2847
Mailing address
PO BOX 188, WEST MEMPHIS, AR 72303
(870) 735-1673
(870) 735-2847

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2346
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0184611
BLUE CROSS BLUE SHIELD
TN
01
156643
UNITED CONCORDIA
01
58956
BLUE CROSS BLUE SHIELD
AR
Enumeration date
01/18/2007
Last updated
07/08/2007
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