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NPI Code Detail

MEDICARE: ROBERT STEPHEN JUDD DDS

MEDICARE: ROBERT STEPHEN JUDD DDS
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 Dentistry00202752CO

General Provider Information

NPI Number : 1972963833
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT STEPHEN JUDD DDS
Provider Business Mailing Address
First Line : 8749 WADSWORTH BLVD
Second Line :
City : WESTMINSTER
State : CO
Zip : 80003-0907
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8749 WADSWORTH BLVD
Second Line :
City : WESTMINSTER
State : CO
Zip : 80003-0907
Country : US
Telephone Number : 303-424-5463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2016
Last Update Date : 03/29/2022

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