Organization
WILD SMILES PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES H HUGHES JR. DDS (OWNER)
(731) 286-1271
Entity
Organization
Contact information
Practice address
1189 VANN DRIVE, JACKSON, TN 38305
(731) 286-1271
(731) 286-0019
Mailing address
1189 VANN DRIVE, JACKSON, TN 38305
(731) 300-0386
(731) 300-0519
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4788
TN
Other
Enumeration date
12/14/2010
Last updated
07/24/2012
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