Provider Demographics
NPI:1679955975
Name:BUNCH, BRITTANY MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:MARIE
Last Name:BUNCH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 COWHORN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-9751
Mailing Address - Country:US
Mailing Address - Phone:903-831-1000
Mailing Address - Fax:903-831-1091
Practice Address - Street 1:5301 COWHORN CREEK RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-9751
Practice Address - Country:US
Practice Address - Phone:903-831-1000
Practice Address - Fax:903-831-1091
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31007122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist