Healthcare Provider Details

I. General information

NPI: 1124077961
Provider Name (Legal Business Name): PAUL CHARLES DUNN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 8TH ST
LEVELLAND TX
79336-4525
US

IV. Provider business mailing address

701 8TH ST
LEVELLAND TX
79336-4525
US

V. Phone/Fax

Practice location:
  • Phone: 806-894-3535
  • Fax: 806-894-7468
Mailing address:
  • Phone: 806-894-3535
  • Fax: 806-894-7468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10309
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: