Healthcare Provider Details

I. General information

NPI: 1205200763
Provider Name (Legal Business Name): ERIC S DUNN DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MCGUFFEY AVE
OXFORD OH
45056-2028
US

IV. Provider business mailing address

600 MCGUFFEY AVE
OXFORD OH
45056-2028
US

V. Phone/Fax

Practice location:
  • Phone: 513-523-7541
  • Fax: 513-523-7542
Mailing address:
  • Phone: 513-523-7541
  • Fax: 513-523-7542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.022862
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC SHANE DUNN
Title or Position: PRESIDENT
Credential: DDS
Phone: 513-523-7541