Healthcare Provider Details

I. General information

NPI: 1497866719
Provider Name (Legal Business Name): DENTAL PLUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 HIGHWAY 190 W SUITE D
DERIDDER LA
70634-6023
US

IV. Provider business mailing address

1808 HIGHWAY 190 W SUITE D
DERIDDER LA
70634-6023
US

V. Phone/Fax

Practice location:
  • Phone: 337-463-6545
  • Fax: 337-460-1966
Mailing address:
  • Phone: 337-463-6545
  • Fax: 337-460-1966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number5236
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2987
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4663
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4421
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5170
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4950
License Number StateLA
# 7
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5449
License Number StateLA

VIII. Authorized Official

Name: DR. CHARLES FRANKLIN HUDSON
Title or Position: OWNER
Credential: DDS
Phone: 337-463-6545