Provider Demographics
NPI:1598957367
Name:STRUTZ, JUDITH MARIE (DDS, MSED)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:MARIE
Last Name:STRUTZ
Suffix:
Gender:F
Credentials:DDS, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 BUSINESS CENTER DR
Mailing Address - Street 2:STE. 8C
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3465
Mailing Address - Country:US
Mailing Address - Phone:909-890-1400
Mailing Address - Fax:
Practice Address - Street 1:1881 BUSINESS CENTER DR
Practice Address - Street 2:STE. 8C
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3465
Practice Address - Country:US
Practice Address - Phone:909-890-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0340011223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics