BRENTON BUNDRICK DDS PLLC NPI 1548724669

NPI Information

NPI: 1548724669
Provider Name: BRENTON BUNDRICK, DDS, PLLC

Doing Business As: MARSHVILLE DENTAL

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
7204 E MARSHVILLE BLVD
MARSHVILLE, NC
ZIP 28103
Phone: (704) 981-1664
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BRENTON BUNDRICK, DDS, PLLC is a dental clinic center in Marshville, NC. BRENTON BUNDRICK, DDS, PLLC NPI is 1548724669. The provider is registered as an organization entity type.
The provider Is Doing Business As Marshville Dental.

The provider's business location address is:

7204 E MARSHVILLE BLVD
MARSHVILLE, NC
ZIP 28103-191
Phone: (704) 981-1664

The provider's authorized official is Brenton Bundrick .
The authorized official title is Manager and has the following contact phone number (704) 960-3909.

The CLIA number assigned to this NPI record is 34D1086190 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/23/2019 and was last updated on 9/13/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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