Healthcare Provider Details

I. General information

NPI: 1740395441
Provider Name (Legal Business Name): HEATHER T. HUDKINS D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 HWY 248 515
BRANSON MO
65616
US

IV. Provider business mailing address

1531 E SUNSHINE ST STE E10
SPRINGFIELD MO
65804-1237
US

V. Phone/Fax

Practice location:
  • Phone: 417-883-5866
  • Fax: 417-883-5898
Mailing address:
  • Phone: 417-883-5866
  • Fax: 417-883-5898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2001013203
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: