# SAMUEL T JUDD DDS LLC

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

## Provider details

- **NPI number:** 1437385465
- **Authorized official:** DR. SAMUEL T JUDD DDS (OWNER)
- **Authorized official phone:** (574) 533-7621

## Contact information

- **Practice address:** 201 PRINGLE DR, GOSHEN, IN 46526-1419
- **Practice address phone:** (574) 533-7621
- **Practice address fax:** (574) 533-1072
- **Mailing address:** 201 PRINGLE DR, GOSHEN, IN 46526-1419
- **Mailing address phone:** (574) 533-7621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12007483 | IN | Yes |

## Other

- **Enumeration date:** 06/04/2009
- **Last updated:** 06/04/2009