Provider Demographics
NPI:1679643951
Name:DUNN, MONICA B (RDH, CDA)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:B
Last Name:DUNN
Suffix:
Gender:F
Credentials:RDH, CDA
Other - Prefix:MRS
Other - First Name:MONICA
Other - Middle Name:M
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDH, CDA
Mailing Address - Street 1:307 BOATNER RD STE 114
Mailing Address - Street 2:
Mailing Address - City:EGLIN AFB
Mailing Address - State:FL
Mailing Address - Zip Code:32542-1302
Mailing Address - Country:US
Mailing Address - Phone:850-883-8712
Mailing Address - Fax:850-883-8328
Practice Address - Street 1:307 BOATNER RD STE 114
Practice Address - Street 2:
Practice Address - City:EGLIN AFB
Practice Address - State:FL
Practice Address - Zip Code:32542-1302
Practice Address - Country:US
Practice Address - Phone:850-883-8712
Practice Address - Fax:850-883-8328
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH10946124Q00000X
PADH009828L124Q00000X
PA113315126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
No126800000XDental ProvidersDental Assistant