MEDICARE: DR. MATTHEW D DUNN DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	D6608	AZ

General Provider Information

NPI Number	:	1619065166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW D DUNN DDS, MS

Provider Business Mailing Address
First Line	:	5220 N. DYSART RD.
Second Line	:	SUITE 150
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-3048
Country	:	US
Telephone Number	:	623-536-4939
Fax Number	:	623-536-4877

Provider Business Practice Location Address
First Line	:	5220 N. DYSART RD.
Second Line	:	SUITE 150
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-3048
Country	:	US
Telephone Number	:	623-536-4939
Fax Number	:	623-536-4877

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/08/2007

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