Provider Demographics
NPI:1891806279
Name:DUNNE, MICHAEL EDMUND (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EDMUND
Last Name:DUNNE
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 1:17 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-3407
Mailing Address - Country:US
Mailing Address - Phone:860-886-2497
Mailing Address - Fax:860-886-6591
Practice Address - Street 1:17 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-3407
Practice Address - Country:US
Practice Address - Phone:860-886-2497
Practice Address - Fax:860-886-6591
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT93591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice