Provider Demographics
NPI:1396963112
Name:HUNT, MICHAEL GUY (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GUY
Last Name:HUNT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4910 VALLEY VIEW BLVD NW STE 201
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-2022
Mailing Address - Country:US
Mailing Address - Phone:540-563-5858
Mailing Address - Fax:540-563-5866
Practice Address - Street 1:4910 VALLEY VIEW BLVD NW STE 201
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-2022
Practice Address - Country:US
Practice Address - Phone:540-563-5858
Practice Address - Fax:540-563-5866
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010067831223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics