Provider Demographics
NPI:1043393747
Name:O'DONNELL, HUGH E (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:E
Last Name:O'DONNELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-7230
Mailing Address - Country:US
Mailing Address - Phone:401-847-3450
Mailing Address - Fax:401-847-3485
Practice Address - Street 1:333 VALLEY RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-7230
Practice Address - Country:US
Practice Address - Phone:401-847-3450
Practice Address - Fax:401-847-3485
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI13811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI8968-5OtherBLUE CROSS #
RI1381OtherDELTA DENTAL OF RI