| Keith A Hudson Dds Pc | |
|
31000 Lahser Rd Suite 7 Beverly Hills MI 48025-4847 | |
| (248) 530-9812 | |
| (248) 530-9815 |
| Full Name | Keith A Hudson Dds Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 31000 Lahser Rd, Beverly Hills, Michigan |
| Authorized Official Name and Position | Keith Allen Hudson (EXECUTIVE DIRECTOR/CEO) |
| Authorized Official Contact | 2485309812 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith A Hudson Dds Pc 31000 Lahser Rd Suite 7 Beverly Hills MI 48025-4847 Ph: (248) 530-9812 | Keith A Hudson Dds Pc 31000 Lahser Rd Suite 7 Beverly Hills MI 48025-4847 Ph: (248) 530-9812 |
| NPI Number | 1417903725 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4880606177 |
|---|---|
| Medicare Enrollment ID | O20060705000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417903725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 015250 (Michigan) | Primary |
| Provider Name | Keith Allen Hudson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1619921459 PECOS PAC ID: 7416969704 Enrollment ID: I20060705000280 |
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