Provider Demographics
NPI:1154494680
Name:HUDEC DENTAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:HUDEC DENTAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUDEC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-485-5788
Mailing Address - Street 1:3327 BROADVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-3315
Mailing Address - Country:US
Mailing Address - Phone:216-485-5788
Mailing Address - Fax:216-485-1257
Practice Address - Street 1:8191 BROADVIEW RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-1661
Practice Address - Country:US
Practice Address - Phone:440-526-5650
Practice Address - Fax:440-526-5165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0152651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty