Provider Demographics
NPI:1316024797
Name:HUDGINS, ALLISON (RDH MS)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:RDH MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23304 S 156TH ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-9580
Mailing Address - Country:US
Mailing Address - Phone:480-821-4845
Mailing Address - Fax:
Practice Address - Street 1:4355 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-7000
Practice Address - Country:US
Practice Address - Phone:480-830-0187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH5553124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist