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General NPI Number Information
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NPI Number | 1881881134
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Entity Type | Individual
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Provider Name | J. MICHAEL DUNN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 11659 S REDWOOD RD
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-7808
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Country | US
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Telephone | 801-253-3010
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Fax | 801-253-9797
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Provider Business Mailing Address
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Address Line | 11659 S REDWOOD RD
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-7808
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Country | US
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Telephone | 801-253-3010
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Fax | 801-253-9797
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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 | 139570-9922
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License Number State | UT
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