Provider Demographics
NPI:1598732810
Name:SOTELO, HUGO A (DMD)
Entity Type:Individual
Prefix:DR
First Name:HUGO
Middle Name:A
Last Name:SOTELO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MASSAND RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-6724
Mailing Address - Country:US
Mailing Address - Phone:508-643-3360
Mailing Address - Fax:
Practice Address - Street 1:55 PLAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-4107
Practice Address - Country:US
Practice Address - Phone:508-643-3360
Practice Address - Fax:508-643-3316
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN025621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIBS5059490OtherFEDERAL