Provider Demographics
NPI:1922050731
Name:HUGHES, WILLIAM RUST (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RUST
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:W.
Other - Middle Name:RUSTY
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1205 N 18TH ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5461
Mailing Address - Country:US
Mailing Address - Phone:318-323-3442
Mailing Address - Fax:
Practice Address - Street 1:1205 N 18TH ST
Practice Address - Street 2:SUITE 113
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5461
Practice Address - Country:US
Practice Address - Phone:318-323-3442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA31591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3159OtherSTATE OF LA