Provider Demographics
NPI:1467557595
Name:JUDD, RONALD MARTIN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MARTIN
Last Name:JUDD
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 WHITE OAKS RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-7130
Mailing Address - Country:US
Mailing Address - Phone:408-377-3366
Mailing Address - Fax:408-377-3074
Practice Address - Street 1:2002 WHITE OAKS RD
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-7130
Practice Address - Country:US
Practice Address - Phone:408-377-3366
Practice Address - Fax:408-377-3074
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA395361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice