Provider Demographics
NPI:1730271693
Name:DUNPHY, DAVID ROBERT (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ROBERT
Last Name:DUNPHY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 CHURCHILL ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126
Mailing Address - Country:US
Mailing Address - Phone:651-483-9800
Mailing Address - Fax:651-483-5264
Practice Address - Street 1:4625 CHURCHILL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126
Practice Address - Country:US
Practice Address - Phone:651-483-9800
Practice Address - Fax:651-483-5264
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND9166122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist