Healthcare Provider Details

I. General information

NPI: 1447369616
Provider Name (Legal Business Name): ROBERT ADRIAN DUNAWAY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 CUMBERLAND AVE
BARBOURVILLE KY
40906-1204
US

IV. Provider business mailing address

240 CUMBERLAND AVE PO BOX 96
BARBOURVILLE KY
40906
US

V. Phone/Fax

Practice location:
  • Phone: 606-546-3660
  • Fax: 606-546-4660
Mailing address:
  • Phone: 606-546-3660
  • Fax: 606-546-4660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6430
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6430
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: