MEDICARE: DR. MICHAEL THOMAS HUGHES DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6537	AZ

General Provider Information

NPI Number	:	1154414142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL THOMAS HUGHES DDS

Provider Business Mailing Address
First Line	:	60 N OLD PUMPHOUSE RD
Second Line	:
City	:	CORNVILLE
State	:	AZ
Zip	:	86325-5704
Country	:	US
Telephone Number	:	928-451-2830
Fax Number	:

Provider Business Practice Location Address
First Line	:	522 W FINNIE FLAT RD STE J
Second Line	:
City	:	CAMP VERDE
State	:	AZ
Zip	:	86322-7265
Country	:	US
Telephone Number	:	928-567-5249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/19/2024

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