Provider Demographics
NPI:1346576832
Name:CHARLES C HUR DMD PC
Entity Type:Organization
Organization Name:CHARLES C HUR DMD PC
Other - Org Name:CHARLES C HUR DMD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-262-0023
Mailing Address - Street 1:315 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01862-2635
Mailing Address - Country:US
Mailing Address - Phone:978-262-0023
Mailing Address - Fax:
Practice Address - Street 1:315 BOSTON RD
Practice Address - Street 2:
Practice Address - City:NORTH BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01862-2635
Practice Address - Country:US
Practice Address - Phone:978-262-0023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARLES C HUR DMD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty