Provider Demographics
NPI:1316046196
Name:HUDSON, ARTHUR LEROY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:LEROY
Last Name:HUDSON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 W KENNETH RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1439
Mailing Address - Country:US
Mailing Address - Phone:818-246-2660
Mailing Address - Fax:
Practice Address - Street 1:428 ARDEN AVE
Practice Address - Street 2:#101
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1108
Practice Address - Country:US
Practice Address - Phone:818-244-2121
Practice Address - Fax:818-244-1956
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA183451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics