Provider Demographics
NPI:1033304944
Name:JUDITH JER VUE
Entity Type:Organization
Organization Name:JUDITH JER VUE
Other - Org Name:FAMILY AND COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:JER
Authorized Official - Last Name:VUE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-429-1325
Mailing Address - Street 1:7260 E SOUTHGATE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2609
Mailing Address - Country:US
Mailing Address - Phone:916-429-1325
Mailing Address - Fax:916-429-1326
Practice Address - Street 1:7260 EAST SOUTHGATE DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823
Practice Address - Country:US
Practice Address - Phone:916-429-1325
Practice Address - Fax:916-429-1326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA492421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty