Provider Demographics
NPI:1871713735
Name:BUNN, TERESA ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ELIZABETH
Last Name:BUNN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:BUNN
Other - Last Name:LEPARIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30 MAGNOLIA RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-9126
Mailing Address - Country:US
Mailing Address - Phone:203-877-3006
Mailing Address - Fax:
Practice Address - Street 1:428 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1233
Practice Address - Country:US
Practice Address - Phone:203-503-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0083611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice