Provider Demographics
NPI:1992439368
Name:MAXWELL HOGUE DDS PLC
Entity type:Organization
Organization Name:MAXWELL HOGUE DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:KURT-PATRICK
Authorized Official - Last Name:HOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-990-5673
Mailing Address - Street 1:5916 EASTMAN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6840
Mailing Address - Country:US
Mailing Address - Phone:989-835-2785
Mailing Address - Fax:
Practice Address - Street 1:5916 EASTMAN AVE STE A
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6840
Practice Address - Country:US
Practice Address - Phone:989-835-2785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental