Provider Demographics
NPI:1215339270
Name:DUNN, THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 BOSQUE PLZ NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2730
Mailing Address - Country:US
Mailing Address - Phone:505-897-2060
Mailing Address - Fax:
Practice Address - Street 1:3710 BOSQUE PLZ NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-2730
Practice Address - Country:US
Practice Address - Phone:505-897-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD44561223X0400X
TX304621223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics