Provider Demographics
NPI:1689855017
Name:BUNN, BEVERLEY JEANNETTE (DDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:BEVERLEY
Middle Name:JEANNETTE
Last Name:BUNN
Suffix:
Gender:F
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1912 VICTORIA CIR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2320
Mailing Address - Country:US
Mailing Address - Phone:806-433-7777
Mailing Address - Fax:469-247-1152
Practice Address - Street 1:4222 TRINITY MILLS RD
Practice Address - Street 2:SUITE 250
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7603
Practice Address - Country:US
Practice Address - Phone:214-646-0870
Practice Address - Fax:214-646-0875
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX196531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics