Provider Demographics
NPI:1174734941
Name:SUNNUCKS, JOHN (DDS)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:SUNNUCKS
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 1:100 S COLLINS FWY
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:TX
Mailing Address - Zip Code:75459-4589
Mailing Address - Country:US
Mailing Address - Phone:903-532-5545
Mailing Address - Fax:
Practice Address - Street 1:100 S COLLINS FWY
Practice Address - Street 2:
Practice Address - City:HOWE
Practice Address - State:TX
Practice Address - Zip Code:75459-4589
Practice Address - Country:US
Practice Address - Phone:903-532-5545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2022-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice