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General NPI Number Information
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NPI Number | 1881811297
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Entity Type | Organization
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Legal Business Name | HUGHES ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 140 S 15TH AVE
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City | LAUREL
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State | MS
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Zip | 39440-4124
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Country | US
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Telephone | 601-649-7800
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Fax | 601-426-6558
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Provider Business Mailing Address
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Address Line | 140 S 15TH AVE
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City | LAUREL
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State | MS
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Zip | 39440-4124
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Country | US
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Telephone | 601-649-7800
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Fax | 601-426-6558
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID OSBURN HUGHES SR.
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Credential | DDA, MS
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Telephone | 601-649-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | OR00777
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License Number State | MS
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