Provider Demographics
NPI:1528259769
Name:HERBERT T. HUDSON, DMD,PA
Entity type:Organization
Organization Name:HERBERT T. HUDSON, DMD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,PA
Authorized Official - Phone:910-295-2750
Mailing Address - Street 1:295 OLMSTED BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9131
Mailing Address - Country:US
Mailing Address - Phone:910-295-2750
Mailing Address - Fax:910-295-3961
Practice Address - Street 1:295 OLMSTED BLVD STE 7
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9131
Practice Address - Country:US
Practice Address - Phone:910-295-2750
Practice Address - Fax:910-295-3961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC54001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty