Organization
LAFAYETTE JUDKINS DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAFAYETTE JUDKINS SR. DDS (DENTIST)
(336) 342-0474
Entity
Organization
Contact information
Practice address
207 TURNER DR, REIDSVILLE, NC 27320-5726
(336) 342-0474
(336) 342-7684
Mailing address
PO BOX 1110, REIDSVILLE, NC 27323-1110
(336) 342-0474
(336) 342-7684
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4781
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8994751
—
NC
01
—
94751
HEALTH CHOICE
NC
Enumeration date
09/22/2006
Last updated
08/22/2020
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