Provider Demographics
NPI:1073730446
Name:DUNAGAN, DAVID D (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:D
Last Name:DUNAGAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17926 HALSTED ST
Mailing Address - Street 2:3-SW
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2029
Mailing Address - Country:US
Mailing Address - Phone:708-798-7940
Mailing Address - Fax:
Practice Address - Street 1:17926 HALSTED ST
Practice Address - Street 2:3-SW
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2029
Practice Address - Country:US
Practice Address - Phone:708-798-7940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01090122421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice