Provider Demographics
NPI:1487069720
Name:CAROLYN M HUNTER D M D P C
Entity type:Organization
Organization Name:CAROLYN M HUNTER D M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:417-847-2461
Mailing Address - Street 1:PO BOX 396
Mailing Address - Street 2:
Mailing Address - City:CASSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65625-0396
Mailing Address - Country:US
Mailing Address - Phone:417-847-2461
Mailing Address - Fax:417-847-4005
Practice Address - Street 1:77 SMITHSON DR
Practice Address - Street 2:
Practice Address - City:CASSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65625-0396
Practice Address - Country:US
Practice Address - Phone:417-847-2461
Practice Address - Fax:417-847-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO13991261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental