Provider Demographics
NPI:1255218202
Name:MCHUGH, DAVIS EDWARD
Entity type:Individual
Prefix:
First Name:DAVIS
Middle Name:EDWARD
Last Name:MCHUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 BETHANY RD STE A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:GA
Mailing Address - Zip Code:30650-4702
Mailing Address - Country:US
Mailing Address - Phone:706-342-3636
Mailing Address - Fax:
Practice Address - Street 1:1880 BETHANY RD STE A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650-4702
Practice Address - Country:US
Practice Address - Phone:706-342-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1239481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice