Provider Demographics
NPI:1891992970
Name:BUNNAO, RACHELLE MOLINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:MOLINA
Last Name:BUNNAO
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 1:2233 WILLAMETTE ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2890
Mailing Address - Country:US
Mailing Address - Phone:541-484-9018
Mailing Address - Fax:
Practice Address - Street 1:2233 WILLAMETTE ST
Practice Address - Street 2:SUITE E
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2890
Practice Address - Country:US
Practice Address - Phone:541-484-9018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD7999122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist