Provider Demographics
NPI:1730660135
Name:WILLIAM J JUDD DMD PA
Entity Type:Organization
Organization Name:WILLIAM J JUDD DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAVON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-546-0734
Mailing Address - Street 1:40 E ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1406
Mailing Address - Country:US
Mailing Address - Phone:856-546-0734
Mailing Address - Fax:
Practice Address - Street 1:40 E ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1406
Practice Address - Country:US
Practice Address - Phone:856-546-0734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental