Provider Demographics
NPI:1467580779
Name:HUDETZ, CHRISTOPHER RICHARD (DDS)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:RICHARD
Last Name:HUDETZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 ENGLISH ROWS AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564
Mailing Address - Country:US
Mailing Address - Phone:630-904-1106
Mailing Address - Fax:630-904-5404
Practice Address - Street 1:3027 ENGLISH ROWS AVE
Practice Address - Street 2:STE 203
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564
Practice Address - Country:US
Practice Address - Phone:630-904-1106
Practice Address - Fax:630-904-5404
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist