Provider Demographics
NPI:1629526769
Name:HG DENTAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:HG DENTAL ASSOCIATES PLLC
Other - Org Name:ROYSE CITY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:EDMON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-636-2417
Mailing Address - Street 1:522 E STATE HIGHWAY 66
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-2914
Mailing Address - Country:US
Mailing Address - Phone:972-636-2417
Mailing Address - Fax:
Practice Address - Street 1:522 E STATE HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-2914
Practice Address - Country:US
Practice Address - Phone:972-636-2417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28529261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental