Provider Demographics
NPI:1235107269
Name:DUDDY, JOSEPH A III (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:DUDDY
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 HIGHWAY 71
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07762
Mailing Address - Country:US
Mailing Address - Phone:732-449-7733
Mailing Address - Fax:732-449-1833
Practice Address - Street 1:1010 HIGHWAY 71
Practice Address - Street 2:
Practice Address - City:SPRING LAKE HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07762
Practice Address - Country:US
Practice Address - Phone:732-449-7733
Practice Address - Fax:732-449-1833
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI16371122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist