Provider Demographics
NPI:1134562010
Name:BAMF DENTAL PLLC DUNKZ DENTAL PLLC MBR
Entity type:Organization
Organization Name:BAMF DENTAL PLLC DUNKZ DENTAL PLLC MBR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-529-8151
Mailing Address - Street 1:7001 PRESTON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-1190
Mailing Address - Country:US
Mailing Address - Phone:214-528-7668
Mailing Address - Fax:214-528-3065
Practice Address - Street 1:7001 PRESTON RD STE 103
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-1190
Practice Address - Country:US
Practice Address - Phone:214-528-7668
Practice Address - Fax:214-528-3065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223X0400X
TX238111223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty