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Licensing details for: 80469

Name: DR. PAGE HUDSON DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Previous Names: HUDSON, PAGE ALLEN

Address of Record

4074 FAIRMOUNT AVE, SUITE B
SAN DIEGO CA 92105
SAN DIEGO county
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Practice Location

4074 FAIRMOUNT AVE, SUITE B
SAN DIEGO CA 92105
SAN DIEGO county
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Issuance Date

January 13, 2020

Expiration Date

September 30, 2020

Current Date / Time

June 7, 2025
1:56:1 PM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: HUDSON, PAGE ALLEN

License/Registration Type: Dentist License

License Number: 36249 Primary Status: Current - Active

Address :
5150 5th St
RAPID CITY SD 57701-6023
PENNINGTON COUNTY

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