Individual provider · Type 1 NPI

Dan Melbourne Prucha, DDS

Periodontics · Fort Gordon, GA

NPI number 1174509202 Active

Practice location

Bldg 38717, 38th Street, Usa Dentac
Fort Gordon, GA 30905-5660

Call (706) 787-6927 Map

Fax (706) 787-2082

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000X20-01-4138 (OH)
Periodontics Primary 1223P0300X30-01-4138 (OH)

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

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About NPI 1174509202

Dan Melbourne Prucha, DDS's National Provider Identifier is 1174509202, issued on Dec 20, 2005. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Fort Gordon, GA. The record was last updated on Sep 11, 2025.