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NPI Code Detail

MEDICARE: DR. DANIEL JOSEPH JUDGE DMD

MEDICARE: DR. DANIEL JOSEPH JUDGE DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryDTP528FL

General Provider Information

NPI Number : 1366583601
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL JOSEPH JUDGE DMD
Provider Business Mailing Address
First Line : 2800 UNIVERSITY BLVD N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-3321
Country : US
Telephone Number : 904-256-7854
Fax Number : 904-256-7798
Provider Business Practice Location Address
First Line : 2800 UNIVERSITY BLVD N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-3321
Country : US
Telephone Number : 904-256-7854
Fax Number : 904-256-7798
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2007
Last Update Date : 08/10/2010

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Directions to “ DR. DANIEL JOSEPH JUDGE DMD” Practice Location

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