MEDICARE: LARRY A DUNN DDS PC

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	10470	TX

General Provider Information

NPI Number	:	1922008309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARRY A DUNN DDS PC

Provider Business Mailing Address
First Line	:	541 W WHEATLAND RD
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4515
Country	:	US
Telephone Number	:	972-298-4677
Fax Number	:

Provider Business Practice Location Address
First Line	:	541 W WHEATLAND RD
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4515
Country	:	US
Telephone Number	:	972-298-4677
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LARRY ALAN DUNN
Credential	:	DDS
Telephone Number	:	972-298-4677

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	08/07/2013

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