# LAFAYETTE JUDKINS DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275632366
- **Authorized official:** DR. LAFAYETTE JUDKINS SR. DDS (DENTIST)
- **Authorized official phone:** (336) 342-0474

## Contact information

- **Practice address:** 207 TURNER DR, REIDSVILLE, NC 27320-5726
- **Practice address phone:** (336) 342-0474
- **Practice address fax:** (336) 342-7684
- **Mailing address:** PO BOX 1110, REIDSVILLE, NC 27323-1110
- **Mailing address phone:** (336) 342-0474
- **Mailing address fax:** (336) 342-7684

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4781 | NC | Yes |

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8994751 | — | NC |
| 01 | — | 94751 | HEALTH CHOICE | NC |