Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN012985 | GA |
NPI | 1053459164 |
---|---|
Provider Name | Dr. Patricia Ann Dunn |
First Address | Kingsland, GA 31548-6728 |
Second Address | Kingsland, GA 31548-6728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 29/05/2008 |