Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 08087 | IA |
NPI | 1245367903 |
---|---|
Provider Name | Dr. James Thomas Dunne JR. |
First Address | Coralville, IA 52241-1175 |
Second Address | Coralville, IA 52241-1175 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 08/07/2007 |