Organization
KIM THOMAS JUDICE, DDS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM THOMAS JUDICE DDS (OWNER)
(337) 988-0020
Entity
Organization
Contact information
Practice address
111 NOEL DR, LAFAYETTE, LA 70503
(337) 988-0020
(337) 988-0244
Mailing address
111 NOEL DR, LAFAYETTE, LA 70503
(337) 988-0020
(337) 988-0244
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3422
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881805
—
LA
Enumeration date
02/28/2007
Last updated
08/22/2020
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