Provider Demographics
NPI:1881811297
Name:HUGHES ORTHODONTICS, PLLC
Entity type:Organization
Organization Name:HUGHES ORTHODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:OSBURN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDA, MS
Authorized Official - Phone:601-649-7800
Mailing Address - Street 1:140 S 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-4124
Mailing Address - Country:US
Mailing Address - Phone:601-649-7800
Mailing Address - Fax:601-426-6558
Practice Address - Street 1:140 S 15TH AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4124
Practice Address - Country:US
Practice Address - Phone:601-649-7800
Practice Address - Fax:601-426-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOR00777261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental