Provider Demographics
NPI:1861852600
Name:JOHN P, BUNKERS DDS
Entity Type:Organization
Organization Name:JOHN P, BUNKERS DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BUNKERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-857-4702
Mailing Address - Street 1:2220 E ROUTE 66
Mailing Address - Street 2:#107
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4694
Mailing Address - Country:US
Mailing Address - Phone:626-857-4702
Mailing Address - Fax:626-857-4703
Practice Address - Street 1:2220 E ROUTE 66
Practice Address - Street 2:#107
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4694
Practice Address - Country:US
Practice Address - Phone:626-857-4702
Practice Address - Fax:626-857-4703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-06
Last Update Date:2016-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27592122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty