Provider Demographics
NPI:1952443772
Name:E JUDD WEST DDS
Entity Type:Organization
Organization Name:E JUDD WEST DDS
Other - Org Name:ROCKY MOUNTAIN PROFESSIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELDON
Authorized Official - Middle Name:JUDD
Authorized Official - Last Name:WEST
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-627-0420
Mailing Address - Street 1:3860 JACKSON AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-1956
Mailing Address - Country:US
Mailing Address - Phone:801-627-0420
Mailing Address - Fax:801-627-0421
Practice Address - Street 1:3860 JACKSON AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-1956
Practice Address - Country:US
Practice Address - Phone:801-627-0420
Practice Address - Fax:801-627-0421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13594199221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty