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General NPI Number Information
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NPI Number | 1437211901
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Entity Type | Individual
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Provider Name | DR. ANNETTE G. DUNFORD
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Gender | Female
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6545 FRANCE AVE S STE 390
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City | EDINA
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State | MN
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Zip | 55435-2121
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Country | US
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Telephone | 952-926-3534
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Fax | 952-926-7085
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Provider Business Mailing Address
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Address Line | 11284 CREEKRIDGE DR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347-4311
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Country | US
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Telephone | 952-944-3222
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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 | D11772
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License Number State | MN
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