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General NPI Number Information
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NPI Number | 1487997474
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Entity Type | Organization
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Legal Business Name | TIM E HUNT DDS PA
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 03/28/2013
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Provider Practice Location Address
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Address Line | 439 N CENTENNIAL AVE
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City | WEST FORK
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State | AR
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Zip | 72774-2708
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Country | US
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Telephone | 479-839-2273
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Fax | 479-839-2274
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Provider Business Mailing Address
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Address Line | 439 N CENTENNIAL AVE P. O. BOX 760
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City | WEST FORK
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State | AR
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Zip | 72774-2708
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Country | US
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Telephone | 479-839-2273
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Fax | 479-839-2274
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIM E. HUNT
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Credential | D.D.S.
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Telephone | 479-839-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2800
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License Number State | AR
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