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General NPI Number Information
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NPI Number | 1487069720
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Entity Type | Organization
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Legal Business Name | CAROLYN M HUNTER D M D P C
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 77 SMITHSON DR
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City | CASSVILLE
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State | MO
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Zip | 65625-0396
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Country | US
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Telephone | 417-847-2461
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Fax | 417-847-4005
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Provider Business Mailing Address
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Address Line | PO BOX 396
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City | CASSVILLE
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State | MO
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Zip | 65625-0396
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Country | US
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Telephone | 417-847-2461
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Fax | 417-847-4005
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. CAROLYN M HUNTER
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Credential | DMD
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Telephone | 417-847-2461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 13991
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License Number State | MO
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