Dan Melbourne Prucha, DDS

Periodontics · Ft Gordon, GA

Individual Active NPI

NPI number 1174509202

Practice location

Bldg 38717, 38TH Street
USA Dentac
Ft Gordon, GA 30905-5660
Phone
(706) 787-6927
Fax
(706) 787-2082

Open in Google Maps

NPI record

NPI
1174509202
Entity type
Individual (Type 1)
Enumeration date
December 20, 2005
Last updated
September 11, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Periodontics Primary 1223P0300X 30-01-4138 OH
Dentist 122300000X 20-01-4138 OH

About Dr. Prucha

Dan Melbourne Prucha, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Periodontics (code 1223P0300X). The practice location is Bldg 38717, 38TH Street, USA Dentac, Ft Gordon, GA 30905-5660. The NPI number 1174509202 was assigned on December 20, 2005 and the record was last updated on September 11, 2025.

Dr. Prucha lists 2 licenses in the registry: #30-01-4138 (OH) for Periodontics; #20-01-4138 (OH) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Dan Melbourne Prucha, DDS?

The NPI number is 1174509202.

What is the phone number of Dr. Prucha?

The phone number listed for the practice location is (706) 787-6927.

Where is Dr. Prucha located?

Bldg 38717, 38TH Street, USA Dentac, Ft Gordon, GA 30905-5660.

What is the taxonomy code for Dr. Prucha?

The primary taxonomy code is 1223P0300X – Periodontics; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Periodontics providers in Ft Gordon

All Periodontics providers in Ft Gordon, GA →