Provider Demographics
NPI:1689652976
Name:JUDY, DAVID LEWIS (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEWIS
Last Name:JUDY
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:8849 SHELBY ST
Mailing Address - Street 2:STE A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-7508
Mailing Address - Country:US
Mailing Address - Phone:317-881-1161
Mailing Address - Fax:317-881-6554
Practice Address - Street 1:8849 SHELBY ST
Practice Address - Street 2:STE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-7508
Practice Address - Country:US
Practice Address - Phone:317-881-1161
Practice Address - Fax:317-881-6554
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN120078711223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics