MEDICARE: HUNTER ORAL & IMPLANT SURGERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)

General Provider Information

NPI Number	:	1437454261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTER ORAL & IMPLANT SURGERY

Provider Business Mailing Address
First Line	:	1324 TROTWOOD AVE
Second Line	:	SUITE 3
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4750
Country	:	US
Telephone Number	:	931-381-0340
Fax Number	:

Provider Business Practice Location Address
First Line	:	1324 TROTWOOD AVE
Second Line	:	SUITE 3
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4750
Country	:	US
Telephone Number	:	931-381-0340
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	WILLIAM HUNTER III
Credential	:	DDS
Telephone Number	:	931-381-0340

Provider Enumeration Date	:	01/26/2011
Last Update Date	:	03/01/2012

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