Provider Demographics
NPI:1194719476
Name:HLUDZIK, GEORGE CHARLES (DMD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CHARLES
Last Name:HLUDZIK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 FAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2526
Mailing Address - Country:US
Mailing Address - Phone:781-225-6324
Mailing Address - Fax:
Practice Address - Street 1:90 VANDENBERG DR
Practice Address - Street 2:66 MDS (AFMC)
Practice Address - City:HANSCOM AFB
Practice Address - State:MA
Practice Address - Zip Code:01731-2104
Practice Address - Country:US
Practice Address - Phone:781-225-6324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19680122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist