Provider Demographics
NPI:1255512273
Name:DUNCAN, GEORGE M (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:M
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11825 STATE ROUTE 40
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUNLAP
Mailing Address - State:IL
Mailing Address - Zip Code:61525-8842
Mailing Address - Country:US
Mailing Address - Phone:309-243-8980
Mailing Address - Fax:309-243-8983
Practice Address - Street 1:11825 STATE ROUTE 40
Practice Address - Street 2:SUITE 100
Practice Address - City:DUNLAP
Practice Address - State:IL
Practice Address - Zip Code:61525-8842
Practice Address - Country:US
Practice Address - Phone:309-243-8980
Practice Address - Fax:309-243-8983
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019025983122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist