Organization
ROY A HUDSON III DDS VANCE AVENUE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY ADRAIN HUDSON III DDS (OWNER/DENTIST)
(901) 526-4442
Entity
Organization
Contact information
Practice address
516 VANCE AVE, MEMPHIS, TN 38126-2117
(901) 526-4442
(901) 526-8523
Mailing address
516 VANCE AVE, MEMPHIS, TN 38126-2117
(901) 526-4442
(901) 526-8523
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0000007059
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3202421
—
TN
Enumeration date
04/04/2008
Last updated
06/18/2008
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