Provider Demographics
NPI:1619154986
Name:HUGHES, GEORGE TILLMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:TILLMAN
Last Name:HUGHES
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 1:512 NE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-7321
Mailing Address - Country:US
Mailing Address - Phone:864-963-4410
Mailing Address - Fax:864-962-0631
Practice Address - Street 1:512 NE MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-7321
Practice Address - Country:US
Practice Address - Phone:864-963-4410
Practice Address - Fax:864-962-0631
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2458122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist