Provider Demographics
NPI:1265754378
Name:HUGHART, DONALD WAYNE (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WAYNE
Last Name:HUGHART
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 32768
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-2768
Mailing Address - Country:US
Mailing Address - Phone:865-692-2380
Mailing Address - Fax:865-692-2382
Practice Address - Street 1:121 S DAVID LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3204
Practice Address - Country:US
Practice Address - Phone:865-692-2380
Practice Address - Fax:865-692-2382
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN83471223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics