=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952434474
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL P HUGHES DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2007
-----------------------------------------------------
Last Update Date | 11/05/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 WILLIAM POPE DR. SUITE 2
-----------------------------------------------------
City | OKATIE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29909-7512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-705-7066
-----------------------------------------------------
Fax | 843-705-7096
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 TELFORD LN
-----------------------------------------------------
City | HILTON HEAD ISLAND
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29926-4207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-682-2636
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 12007867A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 4584
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------