Provider Demographics
NPI:1922491943
Name:BETTY HUGHES DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:BETTY HUGHES DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BABCOCK-HELLRUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-526-7500
Mailing Address - Street 1:4300 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-4700
Mailing Address - Country:US
Mailing Address - Phone:727-526-7500
Mailing Address - Fax:
Practice Address - Street 1:4300 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-4700
Practice Address - Country:US
Practice Address - Phone:727-526-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20621305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization