Provider Demographics
NPI:1124674486
Name:LEMOND C HUNTER DMD PC
Entity type:Organization
Organization Name:LEMOND C HUNTER DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-256-3737
Mailing Address - Street 1:1739 NE 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-1914
Mailing Address - Country:US
Mailing Address - Phone:503-256-3737
Mailing Address - Fax:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service