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General NPI Number Information
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NPI Number | 1609649342
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Entity Type | Organization
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Legal Business Name | NASEM DUNLOP DMD INC
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 27462 PORTOLA PKWY STE 205
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City | FOOTHILL RANCH
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State | CA
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Zip | 92610-2838
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Country | US
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Telephone | 949-668-0686
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Fax |
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Provider Business Mailing Address
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Address Line | 7 PAMELA WAY
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City | COTO DE CAZA
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State | CA
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Zip | 92679-5145
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Country | US
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Telephone | 574-261-4071
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. NASEM M DUNLOP
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Credential | DMD
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Telephone | 574-261-4071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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