Provider Demographics
NPI:1538376967
Name:LOMBARDO, JUDITH (DMD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:LOMBARDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:620 THREE MILE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1617
Mailing Address - Country:US
Mailing Address - Phone:203-758-7733
Mailing Address - Fax:
Practice Address - Street 1:10 MARINE ST
Practice Address - Street 2:SUITE 6
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1470
Practice Address - Country:US
Practice Address - Phone:860-283-5770
Practice Address - Fax:860-283-8335
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0087391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice