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DR. JOHN WATSON BUNTIN DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1750433686

Individual Registrant:
DR. JOHN WATSON BUNTIN DDS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
312 MISSOURI ST  WEST MEMPHIS, AR 72301 US
Tel: 870-735-1673  Fax: 870-735-2847

Contact information for business:
PO BOX 188  WEST MEMPHIS, AR 72303 US
Tel: 870-735-1673  Fax: 870-735-2847

Registration Information:
NPI: 1750433686
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
AR2346

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELD58956AR01
BLUE CROSS BLUE SHIELD0184611TN01
UNITED CONCORDIA15664301




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