Provider Demographics
NPI:1669148540
Name:HUNTER, WAYLAND (DDS)
Entity type:Individual
Prefix:
First Name:WAYLAND
Middle Name:
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 1:1911 PARKVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-5753
Mailing Address - Country:US
Mailing Address - Phone:907-885-4104
Mailing Address - Fax:
Practice Address - Street 1:3465 E MERIDIAN PARK LOOP
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7264
Practice Address - Country:US
Practice Address - Phone:907-373-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK179661122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist