Provider Demographics
NPI:1679729347
Name:HUNT, DALTON L (DDS)
Entity type:Individual
Prefix:DR
First Name:DALTON
Middle Name:L
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:PO BOX 571
Mailing Address - Street 2:
Mailing Address - City:BUHLER
Mailing Address - State:KS
Mailing Address - Zip Code:67522
Mailing Address - Country:US
Mailing Address - Phone:620-543-2768
Mailing Address - Fax:620-543-2736
Practice Address - Street 1:115 N. MAIN
Practice Address - Street 2:
Practice Address - City:BUHLER
Practice Address - State:KS
Practice Address - Zip Code:67522
Practice Address - Country:US
Practice Address - Phone:620-543-2768
Practice Address - Fax:620-543-2736
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100096700AMedicaid