Provider Demographics
NPI:1265194906
Name:HUGHES HOOVER FAMILY DENTISTRY
Entity type:Organization
Organization Name:HUGHES HOOVER FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DESTANEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:225-612-1101
Mailing Address - Street 1:30125 WALKER RD N
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-7302
Mailing Address - Country:US
Mailing Address - Phone:225-612-1101
Mailing Address - Fax:225-612-1105
Practice Address - Street 1:30125 WALKER RD N
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-7302
Practice Address - Country:US
Practice Address - Phone:225-612-1101
Practice Address - Fax:225-612-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty