Provider Demographics
NPI:1205589413
Name:JOHN C TUNNELL DDS MS PLLC
Entity type:Organization
Organization Name:JOHN C TUNNELL DDS MS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:TUNNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:214-287-0831
Mailing Address - Street 1:4144 N CENTRAL EXPY STE 1205
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2190
Mailing Address - Country:US
Mailing Address - Phone:469-640-6730
Mailing Address - Fax:
Practice Address - Street 1:4144 N CENTRAL EXPY STE 1205
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2190
Practice Address - Country:US
Practice Address - Phone:469-640-6730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty