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NPI 1710964945

NPI 1710964945 : STEPHEN DAVID HUCH DMD : GOOSE CREEK, SC

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General NPI Number Information
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    NPI Number           |    1710964945
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    Entity Type          |    Individual 
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    Provider Name        |    STEPHEN DAVID HUCH DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/29/2005
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    504 ST JAMES AVE 
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    City                 |    GOOSE CREEK
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    State                |    SC
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    Zip                  |    29445
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    Country              |    US
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    Telephone            |    843-797-0782
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    Fax                  |    843-797-0454
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Provider Business Mailing Address
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    Address Line         |    504 ST JAMES AVE 
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    City                 |    GOOSE CREEK
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    State                |    SC
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    Zip                  |    29445
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    Country              |    US
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    Telephone            |    843-797-0782
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    Fax                  |    843-797-0454
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    2656
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    License Number State |    SC
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