Provider Demographics
NPI:1992305403
Name:DUNN, BRETT RYAN
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:RYAN
Last Name:DUNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5503 LONG VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64503-1893
Mailing Address - Country:US
Mailing Address - Phone:816-262-0468
Mailing Address - Fax:
Practice Address - Street 1:3022 S BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64503-1547
Practice Address - Country:US
Practice Address - Phone:816-232-9096
Practice Address - Fax:816-232-5029
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist