Provider Demographics
NPI:1992091839
Name:HUNT, PHILIP CLARK (DMD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:CLARK
Last Name:HUNT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 PELHAM RD
Mailing Address - Street 2:PO BOX 25604
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4006
Mailing Address - Country:US
Mailing Address - Phone:864-288-5300
Mailing Address - Fax:864-288-9430
Practice Address - Street 1:2101 PELHAM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4006
Practice Address - Country:US
Practice Address - Phone:864-288-5300
Practice Address - Fax:864-288-9430
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDGD7024GD1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice