=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831562982
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL E. HUGUET DDS AND ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2015
-----------------------------------------------------
Last Update Date | 11/10/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 710 GRAYSON RD
-----------------------------------------------------
City | PLEASANT HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94523-2687
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-945-6204
-----------------------------------------------------
Fax | 925-945-1533
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 710 GRAYSON RD
-----------------------------------------------------
City | PLEASANT HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94523-2687
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-945-6204
-----------------------------------------------------
Fax | 925-945-1533
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/GENERAL DENTIST
-----------------------------------------------------
Name | DR. MICHAEL EDWARD HUGUET
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 925-945-6204
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number | 42962
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------