Provider Demographics
NPI:1841257011
Name:DAVID R HUNTER, D.D.S., PC
Entity type:Organization
Organization Name:DAVID R HUNTER, D.D.S., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-566-4800
Mailing Address - Street 1:6525 W SACK DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7104
Mailing Address - Country:US
Mailing Address - Phone:623-566-4800
Mailing Address - Fax:623-566-4605
Practice Address - Street 1:6525 W SACK DR
Practice Address - Street 2:SUITE 101
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7104
Practice Address - Country:US
Practice Address - Phone:623-566-4800
Practice Address - Fax:623-566-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35411223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ339376OtherD.E.S. CMDP
814380OtherUNITED CONCORDIA