Provider Demographics
NPI:1134557622
Name:DANESTHESIA, INC
Entity type:Organization
Organization Name:DANESTHESIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:801-631-0387
Mailing Address - Street 1:10233 N 6650 W
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-6726
Mailing Address - Country:US
Mailing Address - Phone:801-631-0387
Mailing Address - Fax:
Practice Address - Street 1:5801 S FASHION BLVD STE 190
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6199
Practice Address - Country:US
Practice Address - Phone:801-983-6819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1999804406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty