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General NPI Number Information
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NPI Number | 1619141587
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Entity Type | Organization
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Legal Business Name | SUSAN DUNN D.D.S., P.C.
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 3503 CHANDLER RD
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City | MUSKOGEE
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State | OK
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Zip | 74403-4911
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Country | US
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Telephone | 918-687-3224
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Fax | 918-687-3218
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Provider Business Mailing Address
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Address Line | 3503 CHANDLER RD
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City | MUSKOGEE
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State | OK
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Zip | 74403-4911
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Country | US
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Telephone | 918-687-3224
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Fax | 918-687-3218
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MIKE DUNN
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Credential |
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Telephone | 918-687-3224
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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 |
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License Number State |
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