Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 060183 | NY |
NPI | 1114494911 |
---|---|
Provider Name | Dr. Alf Hitel Bunes |
First Address | Webster, NY 14580-2288 |
Second Address | Webster, NY 14580-2288 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2018 |
Last Update Date | 30/10/2018 |