Organization
BUNCH-GORMAN, LLC
Active
Other names
Innovative Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
JASON K BUNCH D.D.S., M.S. (ORTHODONTIST/ CO-OWNER)
(765) 459-3145
Entity
Organization
Contact information
Practice address
1926 S DIXON RD, KOKOMO, IN 46902-7302
(765) 459-3145
(765) 459-4048
Mailing address
1926 S DIXON RD, KOKOMO, IN 46902-7302
(765) 459-3145
(765) 459-4048
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12010651A
IN
261QD0000X
Dental Clinic/Center
8906IN
IN
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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