Provider Demographics
NPI:1609061613
Name:CHARLES C HUR DMD P.C.
Entity type:Organization
Organization Name:CHARLES C HUR DMD P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-454-9183
Mailing Address - Street 1:51 MILL ST STE 4
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1650
Mailing Address - Country:US
Mailing Address - Phone:781-829-9066
Mailing Address - Fax:781-829-9067
Practice Address - Street 1:51 MILL ST
Practice Address - Street 2:STE 4
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1641
Practice Address - Country:US
Practice Address - Phone:781-829-9066
Practice Address - Fax:781-829-9067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA177771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty