Provider Demographics
NPI:1649287970
Name:HUNTER, NICHOLAS SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:SCOTT
Last Name:HUNTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 S LEWIS AVE
Mailing Address - Street 2:SUITE 222
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6500
Mailing Address - Country:US
Mailing Address - Phone:918-742-1987
Mailing Address - Fax:918-744-0761
Practice Address - Street 1:5319 S LEWIS AVE
Practice Address - Street 2:SUITE 222
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6500
Practice Address - Country:US
Practice Address - Phone:918-742-1987
Practice Address - Fax:918-744-0761
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3593122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist