Provider Demographics
NPI:1467585000
Name:HUDON, JOHN M (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:HUDON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8477 GULF BLVD APT 1002
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-7293
Mailing Address - Country:US
Mailing Address - Phone:334-332-0749
Mailing Address - Fax:
Practice Address - Street 1:101 LECOM WAY
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32435-6323
Practice Address - Country:US
Practice Address - Phone:850-951-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN121611223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics