Provider Demographics
NPI:1396177762
Name:DUNN, LARRY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:ALAN
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 1:541 W WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4515
Mailing Address - Country:US
Mailing Address - Phone:972-298-4677
Mailing Address - Fax:972-298-7140
Practice Address - Street 1:541 W WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4515
Practice Address - Country:US
Practice Address - Phone:972-298-4677
Practice Address - Fax:972-298-7140
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10470122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist