Provider Demographics
NPI:1013694728
Name:MUTUNE, HILDA NJERI (DMD)
Entity Type:Individual
Prefix:DR
First Name:HILDA
Middle Name:NJERI
Last Name:MUTUNE
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 1:1375 FOREST AVE APT H12
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-1865
Mailing Address - Country:US
Mailing Address - Phone:507-313-0528
Mailing Address - Fax:
Practice Address - Street 1:545 EDGEWOOD AVE SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1936
Practice Address - Country:US
Practice Address - Phone:404-589-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-04
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1230871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice