Provider Demographics
NPI:1407919582
Name:HUNT, MILDRED E (DMD)
Entity Type:Individual
Prefix:DR
First Name:MILDRED
Middle Name:E
Last Name:HUNT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WOODROW WILSON DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2539
Mailing Address - Country:US
Mailing Address - Phone:229-242-8088
Mailing Address - Fax:229-242-8281
Practice Address - Street 1:103 WOODROW WILSON DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2539
Practice Address - Country:US
Practice Address - Phone:229-242-8088
Practice Address - Fax:229-242-8281
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN009354122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist