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General NPI Number Information
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NPI Number | 1255453858
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Entity Type | Organization
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Legal Business Name | AMIGO CHILDREN'S DENTAL, PA
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 606 N BEDELL AVE
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City | DEL RIO
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State | TX
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Zip | 78840-4109
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Country | US
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Telephone | 210-391-1775
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W NICHOLSON ST
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City | DEL RIO
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State | TX
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Zip | 78840-5923
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Country | US
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Telephone | 210-391-1775
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. HOWARD HULEN HUNT JR.
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Credential | DDS
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Telephone | 210-391-1775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 20663
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License Number State | TX
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