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General NPI Number Information
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NPI Number | 1811022643
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Entity Type | Individual
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Provider Name | MARY ELLEN HUNT D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 10/12/2009
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Provider Practice Location Address
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Address Line | 6200 FRANK AVE NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-7228
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Country | US
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Telephone | 330-966-5458
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Fax | 330-966-6586
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Provider Business Mailing Address
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Address Line | 95 BLUE HILL LN
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City | FAIRLAWN
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State | OH
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Zip | 44333-3417
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Country | US
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Telephone | 330-873-4780
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16409
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License Number State | OH
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