Provider Demographics
NPI:1821159377
Name:HUDSON, CHRISTINA LOUISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 BRIDGE ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060
Mailing Address - Country:US
Mailing Address - Phone:507-446-9601
Mailing Address - Fax:507-446-9603
Practice Address - Street 1:685 BRIDGE ST
Practice Address - Street 2:SUITE 7
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060
Practice Address - Country:US
Practice Address - Phone:507-446-9601
Practice Address - Fax:507-446-9603
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND110601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice