Individual
USA BUNNAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6501 DEMOCRACY BLVD, BETHESDA, MD 20817-1685
(301) 896-0633
(301) 896-0064
Mailing address
6501 DEMOCRACY BLVD, BETHESDA, MD 20817-1685
(301) 896-0633
(301) 896-0064
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
MD11494
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
699949200
—
MD
Enumeration date
10/27/2005
Last updated
11/13/2015
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