MEDICARE: DR. MATTHEW CLARK DUNN D.M.D.

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	122300000X	Dentist	3441-07	MS
2	122300000X	Dentist	5606	AL

General Provider Information

NPI Number	:	1811185895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW CLARK DUNN D.M.D.

Provider Business Mailing Address
First Line	:	1214 CONCORD AVE
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35213-2121
Country	:	US
Telephone Number	:	601-479-2757
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 MONTEVALLO RD
Second Line	:
City	:	IRONDALE
State	:	AL
Zip	:	35210-3129
Country	:	US
Telephone Number	:	205-595-2273
Fax Number	:

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

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	02/12/2009

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