Individual
TIFFANY HUDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
5363 BALBOA BLVD STE 330, ENCINO, CA 91316-2831
(818) 981-0640
Mailing address
30212 VIA VICTORIA, RANCHO PALOS VERDES, CA 90275-4440
(310) 938-6526
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DDS100923
CA
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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