Healthcare Provider Details

I. General information

NPI: 1851301196
Provider Name (Legal Business Name): NEIL THOMAS DUNBAR DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1469 29TH ST
WEST DES MOINES IA
50266-1302
US

IV. Provider business mailing address

1469 29TH ST
WEST DES MOINES IA
50266-1302
US

V. Phone/Fax

Practice location:
  • Phone: 515-223-6529
  • Fax: 515-223-5448
Mailing address:
  • Phone: 515-223-6529
  • Fax: 515-223-5448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number07728
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: