Provider Demographics
NPI:1124081203
Name:ANDREW J. DUNBAR, DDS, MS, PC
Entity type:Organization
Organization Name:ANDREW J. DUNBAR, DDS, MS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DUNBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:303-688-3837
Mailing Address - Street 1:363 VILLAGE SQUARE LN
Mailing Address - Street 2:SUITE 155
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-3657
Mailing Address - Country:US
Mailing Address - Phone:303-688-3837
Mailing Address - Fax:303-814-0167
Practice Address - Street 1:363 VILLAGE SQUARE LN
Practice Address - Street 2:SUITE 155
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-3657
Practice Address - Country:US
Practice Address - Phone:303-688-3837
Practice Address - Fax:303-814-0167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO77971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty