Provider Demographics
NPI:1437388501
Name:DUNN, TIFFANI BROOKE (DMD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANI
Middle Name:BROOKE
Last Name:DUNN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 SW MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1535
Mailing Address - Country:US
Mailing Address - Phone:210-928-2814
Mailing Address - Fax:
Practice Address - Street 1:2925 GULF FWY S
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6768
Practice Address - Country:US
Practice Address - Phone:281-337-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT2379122300000X
TX26440122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist