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General NPI Number Information
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NPI Number | 1831121581
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Entity Type | Organization
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Legal Business Name | JOHN A HUDEC DDS SPECIALTY SERVICES INC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 3329 BROADVIEW RD
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City | CLEVELAND
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State | OH
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Zip | 44109-3315
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Country | US
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Telephone | 216-661-8100
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Fax | 216-741-3131
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Provider Business Mailing Address
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Address Line | 3329 BROADVIEW RD
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City | CLEVELAND
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State | OH
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Zip | 44109-3315
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Country | US
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Telephone | 216-661-8100
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Fax | 216-741-3131
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN A HUDEC
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Credential | DDS
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Telephone | 216-398-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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