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General NPI Number Information
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NPI Number | 1467585000
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Entity Type | Individual
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Provider Name | JOHN M. HUDON D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 101 LECOM WAY
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City | DEFUNIAK SPRINGS
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State | FL
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Zip | 32435-6323
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Country | US
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Telephone | 850-951-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 8477 GULF BLVD APT 1002
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City | NAVARRE
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State | FL
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Zip | 32566-7293
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Country | US
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Telephone | 334-332-0749
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN12161
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License Number State | FL
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