Provider Demographics
NPI:1043430655
Name:HUDSON, AMBER M (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:M
Last Name:HUDSON
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 1:755 W ROUND BUNCH RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77611-2435
Mailing Address - Country:US
Mailing Address - Phone:409-735-4902
Mailing Address - Fax:409-735-7595
Practice Address - Street 1:755 W ROUND BUNCH RD
Practice Address - Street 2:
Practice Address - City:BRIDGE CITY
Practice Address - State:TX
Practice Address - Zip Code:77611-2435
Practice Address - Country:US
Practice Address - Phone:409-735-4902
Practice Address - Fax:409-735-7595
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice