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General NPI Number Information
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NPI Number | 1679463939
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Entity Type | Individual
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Provider Name | BENJAMIN ROBERT DUNLAP DDS
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Gender | Male
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 8472 SIMONDS ROAD
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City | APO
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State | AA
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Zip | 20755
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Country | US
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Telephone | 301-677-6078
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Fax |
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Provider Business Mailing Address
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Address Line | 9140 MCMAHON CT
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-6767
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Country | US
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Telephone | 614-359-4950
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 18779
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License Number State | MD
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