Dan Melbourne Prucha, DDS Valid NPI
Individual provider · Periodontics · Ft Gordon, GA
- NPI
- 1174509202
- Type
- Individual (Type 1)
- Primary specialty
- Periodontics (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223P0300X
- License number
- 30-01-4138 (OH)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2005-12-20
- Last updated
- 2025-09-11
Practice location
Bldg 38717, 38th Street, Usa Dentac
Ft Gordon, GA 30905-5660
(706) 787-6927