Provider Demographics
NPI:1851310924
Name:DUNN, JEFFREY DUANE (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DUANE
Last Name:DUNN
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9502 CARRIAGE CHASE LN
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-6309
Mailing Address - Country:US
Mailing Address - Phone:801-947-0746
Mailing Address - Fax:
Practice Address - Street 1:4646 LAKE PARK BLVD
Practice Address - Street 2:SUITE N3
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-8212
Practice Address - Country:US
Practice Address - Phone:801-442-7984
Practice Address - Fax:801-442-3006
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT342674-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist