Provider Demographics
NPI:1346404696
Name:CHARLES H. HUDGINS
Entity Type:Organization
Organization Name:CHARLES H. HUDGINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:HUDGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:904-276-0000
Mailing Address - Street 1:767 BLANDING BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-8721
Mailing Address - Country:US
Mailing Address - Phone:904-276-0000
Mailing Address - Fax:
Practice Address - Street 1:767 BLANDING BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-8721
Practice Address - Country:US
Practice Address - Phone:904-276-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty