Provider Demographics
NPI:1427128727
Name:CUNNION, DARA TOMOKO (DMD)
Entity type:Individual
Prefix:DR
First Name:DARA
Middle Name:TOMOKO
Last Name:CUNNION
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 N COURTENAY PKWY
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4126
Mailing Address - Country:US
Mailing Address - Phone:321-454-7148
Mailing Address - Fax:321-449-5015
Practice Address - Street 1:2575 N COURTENAY PKWY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4126
Practice Address - Country:US
Practice Address - Phone:321-454-7148
Practice Address - Fax:321-449-5015
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201721223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry