Individual
VIVIAN J. HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
11711 W. BURLEIGH STREET, WAUWATOSA, WI 53222
(414) 778-5289
(414) 456-9911
Mailing address
11711 W. BURLEIGH, WAUWATOSA, WI 53222
(414) 778-5289
(414) 456-9911
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5951
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33803100
—
WI
Enumeration date
09/21/2006
Last updated
07/08/2007
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