| Dynamic Dental Group, P.C. | |
|
2102 W Randolph St Vandalia IL 62471-1973 | |
| (618) 283-4900 | |
| (618) 283-4963 |
| Full Name | Dynamic Dental Group, P.C. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2102 W Randolph St, Vandalia, Illinois |
| Authorized Official Name and Position | Bradley K. Dunn (PRESIDENT/OWNER) |
| Authorized Official Contact | 6182834900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Dental Group, P.C. 2102 W Randolph St Vandalia IL 62471-1973 Ph: (618) 283-4900 | Dynamic Dental Group, P.C. 2102 W Randolph St Vandalia IL 62471-1973 Ph: (618) 283-4900 |
| NPI Number | 1811062557 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 12/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811062557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 060003846 (Illinois) | Primary |
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