Healthcare Provider Details

I. General information

NPI: 1609942580
Provider Name (Legal Business Name): HUGHES & CHRISTIAN SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 OMRO RD
OSHKOSH WI
54904
US

IV. Provider business mailing address

2202 OMRO RD
OSHKOSH WI
54904
US

V. Phone/Fax

Practice location:
  • Phone: 920-426-4540
  • Fax: 920-426-3230
Mailing address:
  • Phone: 920-426-4540
  • Fax: 920-426-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number4081
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4839
License Number StateWI

VIII. Authorized Official

Name: DR. JOHN PAUL CHRISTIAN
Title or Position: DENTIST OWNER
Credential: DDS
Phone: 920-426-4540