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Individual

HUNTER LAMKIN HAZLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
43025 W 12 MILE RD, NOVI, MI 48377-3012
(502) 774-4401
Mailing address
43025 W 12 MILE RD, NOVI, MI 48377-3012
(502) 774-4401

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
9940
KY
1223P0221X
Pediatric Dentistry
Primary
2901601455
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2901601455
MI SPECIALTY LICENSE - PEDIATRIC DENTISTRY
MI
01
9940
KY DENTAL LICENSE
KY
Enumeration date
06/21/2017
Last updated
03/19/2025
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