Provider Demographics
NPI:1215348065
Name:HUNT, DOMINIQUE C (DDS)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:C
Last Name:HUNT
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 1:11220 PANTHER CREEK PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9395
Mailing Address - Country:US
Mailing Address - Phone:469-269-0997
Mailing Address - Fax:469-812-2349
Practice Address - Street 1:11220 PANTHER CREEK PKWY STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-9395
Practice Address - Country:US
Practice Address - Phone:469-269-0997
Practice Address - Fax:469-812-2349
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA630811223G0001X
TX325601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice