Provider Demographics
NPI:1952446635
Name:BUNDY, ROBERT F JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:BUNDY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 COOPER MORRIS DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3309
Mailing Address - Country:US
Mailing Address - Phone:845-354-4978
Mailing Address - Fax:845-362-0143
Practice Address - Street 1:11 WILBUR RD
Practice Address - Street 2:
Practice Address - City:THIELLS
Practice Address - State:NY
Practice Address - Zip Code:10984
Practice Address - Country:US
Practice Address - Phone:845-947-6205
Practice Address - Fax:845-947-6209
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034532-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist