Healthcare Provider Details

I. General information

NPI: 1982237582
Provider Name (Legal Business Name): CODY ALLEN HUGHES DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8324 CROSSLAND LOOP
MONTGOMERY AL
36117-8482
US

IV. Provider business mailing address

27205 US HIGHWAY 29
ANDALUSIA AL
36421-9467
US

V. Phone/Fax

Practice location:
  • Phone: 334-279-1166
  • Fax:
Mailing address:
  • Phone: 334-804-1978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD-0006755-C1
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: