Provider Demographics
NPI:1720296981
Name:HUNTER, EDWINA F (DDS)
Entity Type:Individual
Prefix:
First Name:EDWINA
Middle Name:F
Last Name:HUNTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-5615
Mailing Address - Country:US
Mailing Address - Phone:870-863-3640
Mailing Address - Fax:870-863-4430
Practice Address - Street 1:481 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-5615
Practice Address - Country:US
Practice Address - Phone:870-863-3640
Practice Address - Fax:870-863-4430
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR22791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice