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General NPI Number Information
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NPI Number | 1578739868
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Entity Type | Organization
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Legal Business Name | GREGORY S HUGHES, D.M.D.,PC
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 2840 HERSHBERGER RD NW STE C
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City | ROANOKE
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State | VA
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Zip | 24017-1915
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Country | US
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Telephone | 540-366-8325
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Fax | 540-366-0685
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Provider Business Mailing Address
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Address Line | 41 ASHBY DR
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City | DALEVILLE
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State | VA
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Zip | 24083-3229
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Country | US
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Telephone | 540-966-0633
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Fax | 540-366-0685
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Authorized Official
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Title or Position | FINANCIAL COORDINATOR
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Name | JOANNE L STULTZ
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Credential |
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Telephone | 540-366-8325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401007630
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License Number State | VA
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