Individual
DR. TYSA MARIE JUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1700 W KOCH ST STE 1, BOZEMAN, MT 59715-4148
(406) 586-4559
Mailing address
1700 W KOCH ST STE 1, BOZEMAN, MT 59715-4148
(406) 586-4559
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DENDENLIC25828
MT
1223G0001X
General Practice Dentistry
D11097
OR
Other
Enumeration date
09/06/2019
Last updated
09/30/2024
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