Provider Demographics
NPI:1255171666
Name:MITCHELL, HUNTER PITMAN (DMD)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:PITMAN
Last Name:MITCHELL
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 1:710 CRESCENT LANDING
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094
Mailing Address - Country:US
Mailing Address - Phone:570-751-3930
Mailing Address - Fax:
Practice Address - Street 1:1335 HANSEL AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4803
Practice Address - Country:US
Practice Address - Phone:859-647-7068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY111181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice