| Roy A Hudson Iii Dds Vance Avenue Dental Clinic | |
|
516 Vance Ave Memphis TN 38126-2117 | |
| (901) 526-4442 | |
| (901) 526-8523 |
| Full Name | Roy A Hudson Iii Dds Vance Avenue Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 516 Vance Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Roy Adrain Hudson (OWNER/DENTIST) |
| Authorized Official Contact | 9015264442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roy A Hudson Iii Dds Vance Avenue Dental Clinic 516 Vance Ave Memphis TN 38126-2117 Ph: (901) 526-4442 | Roy A Hudson Iii Dds Vance Avenue Dental Clinic 516 Vance Ave Memphis TN 38126-2117 Ph: (901) 526-4442 |
| NPI Number | 1063685501 |
|---|---|
| Provider Enumeration Date | 04/04/2008 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063685501 | NPI | - | NPPES |
| 3202421 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS0000007059 (Tennessee) | Primary |
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