Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 2901020091 | MI |
NPI | 1154659381 |
---|---|
Provider Name | Dr. Julius Edwin Bunek II |
First Address | Ann Arbor, MI 48108-5910 |
Second Address | Ann Arbor, MI 48108-3336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2009 |
Last Update Date | 30/11/2009 |