Individual
DR. DAN MELBOURNE PRUCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
BLDG 38717, 38TH STREET, USA DENTAC, FT GORDON, GA 30905-5660
(706) 787-6927
(706) 787-2082
Mailing address
BLDG 38717, 38TH STREET, USA DENTAC, FT GORDON, GA 30905-5660
(706) 787-6927
(706) 787-2082
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
20-01-4138
OH
1223P0300X
Periodontics
Primary
30-01-4138
OH
Other
Enumeration date
12/20/2005
Last updated
09/11/2025
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