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General NPI Number Information
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NPI Number | 1932202264
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Entity Type | Individual
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Provider Name | ANDREW D DUNCKLEE DDS
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 110 NORTH MAIN
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City | DRAYTON
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State | ND
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Zip | 58225
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Country | US
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Telephone | 701-454-6218
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 248
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City | DRAYTON
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State | ND
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Zip | 58225-0248
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Country | US
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Telephone | 701-454-6119
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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 | 1469
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License Number State | ND
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