Provider Demographics
NPI:1265647846
Name:HUGHES, THOMAS EVAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EVAN
Last Name:HUGHES
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 1:1880 WILLOW PARK WAY
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9090
Mailing Address - Country:US
Mailing Address - Phone:719-488-8880
Mailing Address - Fax:719-488-0805
Practice Address - Street 1:1880 WILLOW PARK WAY
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9090
Practice Address - Country:US
Practice Address - Phone:719-488-8880
Practice Address - Fax:719-488-0805
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO71461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice