Provider Demographics
NPI:1437205044
Name:JAMES G HUPP DMD MS PA
Entity Type:Organization
Organization Name:JAMES G HUPP DMD MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:HUPP
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:828-693-5333
Mailing Address - Street 1:689 BLYTHE STREET CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4098
Mailing Address - Country:US
Mailing Address - Phone:828-693-5333
Mailing Address - Fax:828-693-5659
Practice Address - Street 1:689 BLYTHE STREET CT
Practice Address - Street 2:SUITE C
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4098
Practice Address - Country:US
Practice Address - Phone:828-693-5333
Practice Address - Fax:828-693-5659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC67441223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherC- CORPORATION