Provider Demographics
NPI:1497972178
Name:BUNDSCHUH, LAUREN N (DDS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:N
Last Name:BUNDSCHUH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:HANAPEPE
Mailing Address - State:HI
Mailing Address - Zip Code:96716-0527
Mailing Address - Country:US
Mailing Address - Phone:808-335-5554
Mailing Address - Fax:808-335-5591
Practice Address - Street 1:3490 HANAPEPE RD.
Practice Address - Street 2:
Practice Address - City:HANAPEPE
Practice Address - State:HI
Practice Address - Zip Code:96716-0527
Practice Address - Country:US
Practice Address - Phone:808-335-5554
Practice Address - Fax:808-335-5591
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI14441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice