Provider Demographics
NPI:1699824540
Name:NUNEZ, 11HECTOR M (DDS)
Entity Type:Individual
Prefix:DR
First Name:11HECTOR
Middle Name:M
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 W INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-2820
Mailing Address - Country:US
Mailing Address - Phone:602-447-0225
Mailing Address - Fax:602-447-0783
Practice Address - Street 1:4501 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-2820
Practice Address - Country:US
Practice Address - Phone:602-447-0225
Practice Address - Fax:602-447-0783
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice