MEDICARE: DR. JAMES G. HUPP D.M.D

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	1223E0200X	Endodontics	24144	PA

General Provider Information

NPI Number	:	1952457699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES G. HUPP D.M.D

Provider Business Mailing Address
First Line	:	404 MCFARLAN RD
Second Line	:	STE 302
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-2479
Country	:	US
Telephone Number	:	610-925-3440
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 MCFARLAN RD
Second Line	:	STE 302
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-2479
Country	:	US
Telephone Number	:	610-925-3440
Fax Number	:

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	05/16/2011

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