Provider Demographics
NPI:1144255043
Name:DUNNE, DENNIS M (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:M
Last Name:DUNNE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 EXECUTIVE PKWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2138
Mailing Address - Country:US
Mailing Address - Phone:541-485-0175
Mailing Address - Fax:541-344-5129
Practice Address - Street 1:1600 EXECUTIVE PKWY
Practice Address - Street 2:SUITE 350
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2138
Practice Address - Country:US
Practice Address - Phone:541-485-0175
Practice Address - Fax:541-344-5129
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR73231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR150455Medicaid
OR240580Medicaid
OR93-1266899OtherTAX ID