Provider Demographics
NPI:1912037219
Name:DUNN FAMILY DENTAL CARE PC
Entity Type:Organization
Organization Name:DUNN FAMILY DENTAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:260-726-8007
Mailing Address - Street 1:110 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47371-1136
Mailing Address - Country:US
Mailing Address - Phone:260-726-8007
Mailing Address - Fax:260-726-2505
Practice Address - Street 1:110 W NORTH ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371-1136
Practice Address - Country:US
Practice Address - Phone:260-726-8007
Practice Address - Fax:260-726-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN540010741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty