Provider Demographics
NPI:1104968395
Name:SMITH, HUGH C JR (DDS)
Entity type:Individual
Prefix:DR
First Name:HUGH
Middle Name:C
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:303 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2358
Mailing Address - Country:US
Mailing Address - Phone:662-843-5011
Mailing Address - Fax:662-846-6527
Practice Address - Street 1:303 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2358
Practice Address - Country:US
Practice Address - Phone:662-843-5011
Practice Address - Fax:662-846-6527
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1699751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry