Provider Demographics
NPI:1336583525
Name:HURLEY FAMILY DENTAL CARE
Entity Type:Organization
Organization Name:HURLEY FAMILY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:IV
Authorized Official - Credentials:DMD
Authorized Official - Phone:228-588-6027
Mailing Address - Street 1:7305 HWY 614
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:MS
Mailing Address - Zip Code:39555
Mailing Address - Country:US
Mailing Address - Phone:228-588-6027
Mailing Address - Fax:228-588-0255
Practice Address - Street 1:7305 HIGHWAY 614
Practice Address - Street 2:
Practice Address - City:MOSS POINT
Practice Address - State:MS
Practice Address - Zip Code:39562-6369
Practice Address - Country:US
Practice Address - Phone:228-588-6027
Practice Address - Fax:228-588-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty