Provider Demographics
NPI:1811185895
Name:DUNN, MATTHEW CLARK (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:CLARK
Last Name:DUNN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2121
Mailing Address - Country:US
Mailing Address - Phone:601-479-2757
Mailing Address - Fax:
Practice Address - Street 1:4500 MONTEVALLO RD
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-3129
Practice Address - Country:US
Practice Address - Phone:205-595-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3441-07122300000X
AL5606122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist