Provider Demographics
NPI:1598984262
Name:DR. HUGH'S DENTAL PC
Entity Type:Organization
Organization Name:DR. HUGH'S DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HUBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:IV
Authorized Official - Credentials:DDS, MPH
Authorized Official - Phone:603-444-4141
Mailing Address - Street 1:209 COTTAGE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-4100
Mailing Address - Country:US
Mailing Address - Phone:603-444-4141
Mailing Address - Fax:
Practice Address - Street 1:209 COTTAGE ST STE 1
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-4100
Practice Address - Country:US
Practice Address - Phone:603-444-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH34641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1012723Medicaid
NH30314177Medicaid