Individual
LISA M JUDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
3932 HIGHWAY 90 W, AVONDALE, LA 70094-2648
(504) 436-2223
Mailing address
PO BOX 2490, MARRERO, LA 70073-2490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4430
LA
1223G0001X
General Practice Dentistry
DN011180
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000764112B
—
GA
05
—
1844306
—
LA
Enumeration date
07/23/2008
Last updated
01/19/2023
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