Provider Demographics
NPI:1871685586
Name:SCOTT A. HUDIMAC DDS,INC
Entity Type:Organization
Organization Name:SCOTT A. HUDIMAC DDS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HUDIMAC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-537-5505
Mailing Address - Street 1:5938 STATE ROUTE 981
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2685
Mailing Address - Country:US
Mailing Address - Phone:724-537-5505
Mailing Address - Fax:724-539-3906
Practice Address - Street 1:5938 STATE ROUTE 981
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2685
Practice Address - Country:US
Practice Address - Phone:724-537-5505
Practice Address - Fax:724-539-3906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027590L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty