Provider Demographics
NPI:1609067636
Name:HUNTER, LEMOND C (DMD)
Entity Type:Individual
Prefix:
First Name:LEMOND
Middle Name:C
Last Name:HUNTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1739 NE 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230
Mailing Address - Country:US
Mailing Address - Phone:503-256-3737
Mailing Address - Fax:503-252-3158
Practice Address - Street 1:1739 NE 122ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1914
Practice Address - Country:US
Practice Address - Phone:503-256-3737
Practice Address - Fax:503-252-3158
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD89611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice