Provider Demographics
NPI:1104043611
Name:HUGHES, DAVID OSBURN SR (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:OSBURN
Last Name:HUGHES
Suffix:SR
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-4124
Mailing Address - Country:US
Mailing Address - Phone:601-649-7800
Mailing Address - Fax:601-426-6558
Practice Address - Street 1:140 S 15TH AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4124
Practice Address - Country:US
Practice Address - Phone:601-649-7800
Practice Address - Fax:601-426-6558
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOR007771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics