Provider Demographics
NPI:1437660495
Name:HUGHEY, ABIGAIL (RDH)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HUGHEY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 STONE CANYON RD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-7319
Mailing Address - Country:US
Mailing Address - Phone:720-884-6187
Mailing Address - Fax:
Practice Address - Street 1:1121 STONE CANYON RD
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-7319
Practice Address - Country:US
Practice Address - Phone:720-884-6187
Practice Address - Fax:720-884-6187
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO905830124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist