Provider Demographics
NPI:1669755633
Name:HUD, NATALIA SOPHIA (DMD)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:SOPHIA
Last Name:HUD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SHEPPARD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4787
Mailing Address - Country:US
Mailing Address - Phone:856-751-6546
Mailing Address - Fax:
Practice Address - Street 1:2 SHEPPARD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4787
Practice Address - Country:US
Practice Address - Phone:856-751-6546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI024842001223G0001X
PADS0388441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice