Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 4934T | NV |
NPI | 1225168735 |
---|---|
Provider Name | Nicholas J Bunk |
First Address | Nixon, NV 89424-0227 |
Second Address | Nixon, NV 89424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 28/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4934T | (02) | NV |