MEDICARE: RICHARD B DUNN DDS

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	041523	NY

General Provider Information

NPI Number	:	1831164987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD B DUNN DDS

Provider Business Mailing Address
First Line	:	1007 BROADWAY
Second Line	:
City	:	ELMIRA
State	:	NY
Zip	:	14904
Country	:	US
Telephone Number	:	607-734-2045
Fax Number	:	607-734-6103

Provider Business Practice Location Address
First Line	:	1007 BROADWAY
Second Line	:
City	:	ELMIRA
State	:	NY
Zip	:	14904
Country	:	US
Telephone Number	:	607-734-2045
Fax Number	:	607-734-6103

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	07/08/2007

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