Provider Demographics
NPI:1003685470
Name:HUGHES DENTAL CORP
Entity Type:Organization
Organization Name:HUGHES DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-523-2161
Mailing Address - Street 1:20930 BONITA ST STE X
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3682
Mailing Address - Country:US
Mailing Address - Phone:310-523-2161
Mailing Address - Fax:
Practice Address - Street 1:20930 BONITA ST STE X
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3682
Practice Address - Country:US
Practice Address - Phone:310-523-2161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental