Provider Demographics
NPI:1437447398
Name:TUKDI, MUDDASAR (DMD)
Entity Type:Individual
Prefix:
First Name:MUDDASAR
Middle Name:
Last Name:TUKDI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5611 DALTON RANCH LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4530
Mailing Address - Country:US
Mailing Address - Phone:832-641-1119
Mailing Address - Fax:
Practice Address - Street 1:5611 DALTON RANCH LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4530
Practice Address - Country:US
Practice Address - Phone:832-641-1119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27183122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist