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General NPI Number Information
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NPI Number | 1134928468
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Entity Type | Individual
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Provider Name | HUNTER SHELBY FREI DMD
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Gender | Male
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 510 E 23RD ST
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City | PANAMA CITY
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State | FL
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Zip | 32405-5308
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Country | US
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Telephone | 850-532-6068
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Fax |
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Provider Business Mailing Address
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Address Line | 290 LE GRANDE CIR
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City | SANTA CLARA
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State | UT
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Zip | 84765-5630
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Country | US
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Telephone | 435-705-9641
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN30149
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License Number State | FL
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