Provider Demographics
NPI:1891778320
Name:DUNKERLY, PAUL W (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:W
Last Name:DUNKERLY
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:PO BOX 656
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-0656
Mailing Address - Country:US
Mailing Address - Phone:812-847-8646
Mailing Address - Fax:812-847-8761
Practice Address - Street 1:190 C ST NW
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:IN
Practice Address - Zip Code:47441-1328
Practice Address - Country:US
Practice Address - Phone:812-847-8646
Practice Address - Fax:812-847-8761
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN7984122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist