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General NPI Number Information
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NPI Number | 1639201007
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Entity Type | Organization
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Legal Business Name | DANIEL HUDSON DMD PC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1666 S FOREST AVE
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City | LUVERNE
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State | AL
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Zip | 36049-7305
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Country | US
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Telephone | 334-335-3697
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Fax | 334-335-4128
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Provider Business Mailing Address
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Address Line | 1666 S FOREST AVE
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City | LUVERNE
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State | AL
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Zip | 36049-7305
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Country | US
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Telephone | 334-335-3697
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Fax | 334-335-4128
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL COWEN HUDSON
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Credential | AO
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Telephone | 334-335-3697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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