Provider Demographics
NPI:1447945928
Name:BUNDY FAMILY DENTISTRY
Entity type:Organization
Organization Name:BUNDY FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:BUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-521-3560
Mailing Address - Street 1:155 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68003-1504
Mailing Address - Country:US
Mailing Address - Phone:402-521-3560
Mailing Address - Fax:402-671-0518
Practice Address - Street 1:155 N 24TH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:NE
Practice Address - Zip Code:68003-1504
Practice Address - Country:US
Practice Address - Phone:402-521-3560
Practice Address - Fax:402-671-0518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental