Individual
DR. GURSIMRAT K JUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
GREAT LAKES DENTAL SERVICES, PC, 107 E CHESTNUT ST., ROME, NY 13440
(315) 336-0494
Mailing address
5104 WATERFORD WOODWAY, FAYETTEVILLE, NY 13066
(315) 336-0494
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
045649
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01552501
—
NY
Enumeration date
05/02/2007
Last updated
07/08/2007
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