Provider Demographics
NPI:1508927864
Name:DR W MICHAEL HUDGINS PC
Entity Type:Organization
Organization Name:DR W MICHAEL HUDGINS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HUDGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-556-2530
Mailing Address - Street 1:2979 RIVER ROAD WEST PO BOX 969
Mailing Address - Street 2:
Mailing Address - City:GOOCHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23063-0969
Mailing Address - Country:US
Mailing Address - Phone:804-556-2530
Mailing Address - Fax:
Practice Address - Street 1:2979 RIVER ROAD WEST
Practice Address - Street 2:
Practice Address - City:GOOCHLAND
Practice Address - State:VA
Practice Address - Zip Code:23063-0969
Practice Address - Country:US
Practice Address - Phone:804-556-2530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010064811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty