Provider Demographics
NPI:1801019336
Name:JUDD, LYNN STERLING (DDS)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:STERLING
Last Name:JUDD
Suffix:
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 1:1568 CREEKSIDE DR
Mailing Address - Street 2:STE 101
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3449
Mailing Address - Country:US
Mailing Address - Phone:916-983-1999
Mailing Address - Fax:916-983-3334
Practice Address - Street 1:1568 CREEKSIDE DR
Practice Address - Street 2:STE 101
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3449
Practice Address - Country:US
Practice Address - Phone:916-983-1999
Practice Address - Fax:916-983-3334
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26655122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist