| Khudsonandcbarberdmdpc | |
|
100 Howard Ln Fayetteville GA 30215-1849 | |
| (770) 461-9935 | |
| (770) 461-3871 |
| Full Name | Khudsonandcbarberdmdpc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Howard Ln, Fayetteville, Georgia |
| Authorized Official Name and Position | Walter Kenneth Hudson (DENTIST) |
| Authorized Official Contact | 7704619935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Khudsonandcbarberdmdpc 100 Howard Ln Fayetteville GA 30215-1849 Ph: (770) 461-9935 | Khudsonandcbarberdmdpc 100 Howard Ln Fayetteville GA 30215-1849 Ph: (770) 461-9935 |
| NPI Number | 1760532899 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 08/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760532899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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