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Organization
THOMAS P JUDD DDS LLC
Active
Organization
THOMAS P JUDD DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS PHILLIP JUDD DDS (DENTIST)
(574) 533-7621
Entity
Organization
Contact information
Practice address
201 PRINGLE DR, GOSHEN, IN 46526-1419
(574) 533-7621
(574) 533-1072
Mailing address
201 PRINGLE DR, GOSHEN, IN 46526-1419
(574) 533-7621
(574) 533-1072
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12011153A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952565772
INDIVIDUAL NPI
—
Enumeration date
11/26/2017
Last updated
11/27/2017
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