Provider Demographics
NPI:1457516908
Name:MELISSA A. HUNT, D.D.S., P.A.
Entity Type:Organization
Organization Name:MELISSA A. HUNT, D.D.S., P.A.
Other - Org Name:FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:936-295-6811
Mailing Address - Street 1:2402 SAM HOUSTON AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-5861
Mailing Address - Country:US
Mailing Address - Phone:936-295-6811
Mailing Address - Fax:936-291-8128
Practice Address - Street 1:2402 SAM HOUSTON AVE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-5861
Practice Address - Country:US
Practice Address - Phone:936-295-6811
Practice Address - Fax:936-291-8128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20322122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty