Provider Demographics
NPI:1649346396
Name:BOYKO TORGERSON, JUDITH ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:BOYKO TORGERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SCRIPPS DRIVE
Mailing Address - Street 2:304
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6207
Mailing Address - Country:US
Mailing Address - Phone:916-929-0100
Mailing Address - Fax:916-929-0101
Practice Address - Street 1:2 SCRIPPS DRIVE
Practice Address - Street 2:304
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6207
Practice Address - Country:US
Practice Address - Phone:916-929-0100
Practice Address - Fax:916-929-0101
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3202901OtherDENTI CAL STATE