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General NPI Number Information
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NPI Number | 1194033423
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Entity Type | Individual
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Provider Name | ALFRED EUGENE DUNHAM JR. DDS
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Gender | Male
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 09/21/2010
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Provider Practice Location Address
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Address Line | 1800 N 16TH ST DUPLEX 1
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City | CLARINDA
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State | IA
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Zip | 51632-1101
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Country | US
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Telephone | 712-438-4030
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 N 16TH ST DUPLEX 1
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City | CLARINDA
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State | IA
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Zip | 51632-1101
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Country | US
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Telephone | 712-438-4030
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 06421
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License Number State | IA
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