Provider Demographics
NPI:1467893586
Name:HUDSDON, PAUL G
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:G
Last Name:HUDSDON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 RAINTREE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-4228
Mailing Address - Country:US
Mailing Address - Phone:804-740-8320
Mailing Address - Fax:804-740-8263
Practice Address - Street 1:1801 RAINTREE DR
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-4228
Practice Address - Country:US
Practice Address - Phone:804-740-8320
Practice Address - Fax:804-740-8263
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist