| Thomas P Judd Dds Llc | |
|
201 Pringle Dr Goshen IN 46526-1419 | |
| (574) 533-7621 | |
| (574) 533-1072 |
| Full Name | Thomas P Judd Dds Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 201 Pringle Dr, Goshen, Indiana |
| Authorized Official Name and Position | Thomas Phillip Judd (DENTIST) |
| Authorized Official Contact | 5745337621 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas P Judd Dds Llc 201 Pringle Dr Goshen IN 46526-1419 Ph: (574) 533-7621 | Thomas P Judd Dds Llc 201 Pringle Dr Goshen IN 46526-1419 Ph: (574) 533-7621 |
| NPI Number | 1801300082 |
|---|---|
| Provider Enumeration Date | 11/26/2017 |
| Last Update Date | 11/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801300082 | NPI | - | NPPES |
| 1952565772 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 12011153A (Indiana) | Primary |
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