Individual
DR. HEATHER JUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 669-3154
Mailing address
3015 DAYTONA AVE, LAKE HAVASU CITY, AZ 86403-5445
(928) 855-8373
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4196-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
918344
—
AZ
Enumeration date
09/14/2006
Last updated
07/08/2007
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