Provider Demographics
NPI:1326363094
Name:BROOKS DUNSTON DDS PLLC
Entity Type:Organization
Organization Name:BROOKS DUNSTON DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-499-9950
Mailing Address - Street 1:55 AMARILLO LANE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332
Mailing Address - Country:US
Mailing Address - Phone:919-499-9950
Mailing Address - Fax:
Practice Address - Street 1:55 AMARILLO LANE
Practice Address - Street 2:BUFFALO LAKE BUSINESS PARK
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332
Practice Address - Country:US
Practice Address - Phone:919-499-9950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76831223G0001X
NC80901223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty