Provider Demographics
NPI:1427160787
Name:DAVID M. BUNKALL, D.D.S., M.S., P.C.
Entity type:Organization
Organization Name:DAVID M. BUNKALL, D.D.S., M.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BUNKALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:801-544-1184
Mailing Address - Street 1:195 E GENTILE ST
Mailing Address - Street 2:SUITE #11
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-3754
Mailing Address - Country:US
Mailing Address - Phone:801-544-1184
Mailing Address - Fax:801-544-9436
Practice Address - Street 1:195 E GENTILE ST
Practice Address - Street 2:SUITE #11
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-3754
Practice Address - Country:US
Practice Address - Phone:801-544-1184
Practice Address - Fax:801-544-9436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2942629921261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental