Provider Demographics
NPI:1730392010
Name:DAVID CARROLL HUGHES DDS PC
Entity type:Organization
Organization Name:DAVID CARROLL HUGHES DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CARROLL
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:706-595-5152
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-0366
Mailing Address - Country:US
Mailing Address - Phone:706-595-5152
Mailing Address - Fax:706-597-1535
Practice Address - Street 1:540 WEST HILL STREET
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-0366
Practice Address - Country:US
Practice Address - Phone:706-595-5152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7322122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty