Provider Demographics
NPI:1578739868
Name:GREGORY S HUGHES, D.M.D.,PC
Entity Type:Organization
Organization Name:GREGORY S HUGHES, D.M.D.,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-366-8325
Mailing Address - Street 1:41 ASHBY DR
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3229
Mailing Address - Country:US
Mailing Address - Phone:540-966-0633
Mailing Address - Fax:540-366-0685
Practice Address - Street 1:2840 HERSHBERGER RD NW STE C
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-1915
Practice Address - Country:US
Practice Address - Phone:540-366-8325
Practice Address - Fax:540-366-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010076301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty