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General NPI Number Information
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NPI Number | 1629134820
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Entity Type | Individual
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Provider Name | CLIFFORD GREGORY DUNN O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | WAL MART VISION CENTER 1549 ROUTE 9
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City | HALFMOON
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State | NY
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Zip | 12065-5603
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Country | US
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Telephone | 518-373-5756
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Fax | 518-373-5759
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Provider Business Mailing Address
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Address Line | 43 OMEGA TER
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City | LATHAM
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State | NY
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Zip | 12110-1957
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Country | US
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Telephone | 518-785-4424
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | T005588
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License Number State | NY
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