=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952381584
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | C.H. HUGHES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2006
-----------------------------------------------------
Last Update Date | 07/24/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 95 HWY 51 BYPASS WEST
-----------------------------------------------------
City | DYERSBURG
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-286-1271
-----------------------------------------------------
Fax | 731-286-8034
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 95 HWY 51 BYPASS WEST
-----------------------------------------------------
City | DYERSBURG
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-286-1271
-----------------------------------------------------
Fax | 731-286-8034
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PEDIATRIC DENTIST/OWNER
-----------------------------------------------------
Name | DR. CHARLES H HUGHES JR.
-----------------------------------------------------
Credential | DDS MS
-----------------------------------------------------
Telephone | 731-286-1271
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------