Provider Demographics
NPI:1821023177
Name:HUGHES, AMY ELISE (DDS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELISE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5509 EDEN PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-5839
Mailing Address - Country:US
Mailing Address - Phone:952-938-6038
Mailing Address - Fax:952-935-9175
Practice Address - Street 1:5509 EDEN PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-5839
Practice Address - Country:US
Practice Address - Phone:952-938-6038
Practice Address - Fax:952-935-9175
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11282122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist