Provider Demographics
NPI:1689829988
Name:DUNN, FORREST MANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:FORREST
Middle Name:MANN
Last Name:DUNN
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 1:206 EAST CEDAR
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515
Mailing Address - Country:US
Mailing Address - Phone:979-849-3741
Mailing Address - Fax:979-849-5970
Practice Address - Street 1:206 EAST CEDAR
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515
Practice Address - Country:US
Practice Address - Phone:979-849-3741
Practice Address - Fax:979-849-5970
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9779DENTALLICENSE1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
9779OtherTEXAS DENTAL LICENSE