Provider Demographics
NPI:1063584654
Name:HUDSON-CHARLES-PIERRE, MONIQUE (DDS)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:
Last Name:HUDSON-CHARLES-PIERRE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139B N CHARLOTTE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110
Mailing Address - Country:US
Mailing Address - Phone:704-289-1105
Mailing Address - Fax:704-289-6269
Practice Address - Street 1:1139B N CHARLOTTE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110
Practice Address - Country:US
Practice Address - Phone:704-289-1105
Practice Address - Fax:704-289-6269
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC73701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC899019KMedicaid