Individual
DR. MARY ALICE VICKERY HUGHES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
545 VERDAE BLVD STE A, GREENVILLE, SC 29607
(864) 676-9873
Mailing address
545 VERDAE BLVD STE A, GREENVILLE, SC 29607-4021
(864) 676-9873
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN20661
FL
1223G0001X
General Practice Dentistry
8103
SC
1223P0221X
Pediatric Dentistry
Primary
8103
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX8103
—
SC
Enumeration date
07/05/2012
Last updated
09/12/2019
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