Provider Demographics
NPI:1871657817
Name:DUNN, GREGORY W (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:W
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 1:102 MARTY DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-9305
Mailing Address - Country:US
Mailing Address - Phone:763-682-4512
Mailing Address - Fax:763-682-5069
Practice Address - Street 1:102 MARTY DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-9305
Practice Address - Country:US
Practice Address - Phone:763-682-4512
Practice Address - Fax:763-682-5069
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND84461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice