Provider Demographics
NPI:1750778114
Name:DUNN, ALDEN
Entity type:Individual
Prefix:
First Name:ALDEN
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5546 CAMINO AL NORTE
Mailing Address - Street 2:SUITE 2163
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0805
Mailing Address - Country:US
Mailing Address - Phone:702-998-9993
Mailing Address - Fax:
Practice Address - Street 1:5546 CAMINO AL NORTE
Practice Address - Street 2:SUITE 2163
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-0805
Practice Address - Country:US
Practice Address - Phone:702-998-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner