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General NPI Number Information
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NPI Number | 1104423128
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Entity Type | Individual
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Provider Name | BRANDON HUNT DDS
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Gender | Male
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Dates
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Enumeration Date | 10/02/2020
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 845 SW 17TH ST STE 201
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City | REDMOND
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State | OR
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Zip | 97756-2576
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Country | US
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Telephone | 541-504-0880
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Fax |
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Provider Business Mailing Address
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Address Line | 715 W 22ND AVE
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City | SPOKANE
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State | WA
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Zip | 99203-1961
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Country | US
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Telephone | 509-953-5329
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 61100059
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D11578
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License Number State | OR
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