Bunch, Frederick Lyle

Bunch, Frederick Lyle is an individual health care provider with primary practice located at 756 Porter Ave Suite 400, Stockton CA 95207-4232. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Bunch, Frederick Lyle can be contacted via phone (209) 951-6387.

Contact Information

Primary practice address
756 Porter Ave Suite 400 Stockton CA 95207-4232
Phone: (209) 951-6387
Fax: (209) 951-2824
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 21974 California

Profile Details

NPI number 1912910589
LBN Legal business name Bunch, Frederick Lyle
Credentials D.D.S., M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912910589 NPPES
California MEDICAID B2197401

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