Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 30.023904 | OH |
Y | 1223D0001X | Dental Public Health | DN015775 | GA |
NPI | 1205178308 |
---|---|
Provider Name | Dr. Kendra Lynette Hunter |
First Address | Columbus, GA 31903-2834 |
Second Address | Columbus, GA 31903-2834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 04/10/2021 |