Provider Demographics
NPI:1902021421
Name:MILLS, WES HUNTER (DMD)
Entity Type:Individual
Prefix:DR
First Name:WES
Middle Name:HUNTER
Last Name:MILLS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:WES
Other - Middle Name:H
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:203 E NORTH ST
Mailing Address - Street 2:P.O. BOX 557
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-1628
Mailing Address - Country:US
Mailing Address - Phone:270-247-0500
Mailing Address - Fax:270-247-0522
Practice Address - Street 1:203 E NORTH ST
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-1628
Practice Address - Country:US
Practice Address - Phone:270-247-0500
Practice Address - Fax:270-247-0522
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6133122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist