Provider Demographics
NPI:1740403245
Name:DUNHAM & DUNHAM DDS
Entity Type:Organization
Organization Name:DUNHAM & DUNHAM DDS
Other - Org Name:MICHAEL R DUNHAM DDS & JUDITH G DUNHAM DDS PC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:DUNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:325-573-3162
Mailing Address - Street 1:3701 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-4630
Mailing Address - Country:US
Mailing Address - Phone:325-573-4115
Mailing Address - Fax:
Practice Address - Street 1:3701 AVENUE U
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549-4630
Practice Address - Country:US
Practice Address - Phone:325-573-3162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120011223G0001X
TX124311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty