Healthcare Provider Details

I. General information

NPI: 1508927864
Provider Name (Legal Business Name): DR W MICHAEL HUDGINS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2979 RIVER ROAD WEST
GOOCHLAND VA
23063-0969
US

IV. Provider business mailing address

2979 RIVER ROAD WEST PO BOX 969
GOOCHLAND VA
23063-0969
US

V. Phone/Fax

Practice location:
  • Phone: 804-556-2530
  • Fax:
Mailing address:
  • Phone: 804-556-2530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401006481
License Number StateVA

VIII. Authorized Official

Name: DR. WILLIAM MICHAEL HUDGINS
Title or Position: PRESIDENT
Credential: DDS
Phone: 804-556-2530