Provider Demographics
NPI:1285885210
Name:DUNHAM, RICHARD BRYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BRYAN
Last Name:DUNHAM
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 1:219 E TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:DALHART
Mailing Address - State:TX
Mailing Address - Zip Code:79022-4321
Mailing Address - Country:US
Mailing Address - Phone:806-249-5538
Mailing Address - Fax:806-249-5530
Practice Address - Street 1:219 E TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:DALHART
Practice Address - State:TX
Practice Address - Zip Code:79022-4321
Practice Address - Country:US
Practice Address - Phone:806-249-5538
Practice Address - Fax:806-249-5530
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice