Provider Demographics
NPI:1740470574
Name:HUGHES, DIANE (DMD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4901 LARCHMONT DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2938
Mailing Address - Country:US
Mailing Address - Phone:505-271-0305
Mailing Address - Fax:505-899-6980
Practice Address - Street 1:2401-D CABEZON BOULEVARD
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124
Practice Address - Country:US
Practice Address - Phone:505-271-0305
Practice Address - Fax:505-899-6980
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD29721223X0400X
NY0462501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics