Organization · NPI-2

Ladd Dental Group Of Peru, P.C.

Dentist, General Practice · Peru, IN

NPI number1093017907
StatusActive
Last updated in NPPESNov 29, 2010

Details

NPI
1093017907
Entity type
Organization (NPI-2)
Legal business name
Ladd Dental Group Of Peru, P.C.
Organization subpart
No
Enumeration date
Nov 29, 2010
Last updated
Nov 29, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice7486INYes

Practice location

980 N Broadway
Peru, IN 46970-1070

Phone 765-473-0141

Mailing address

2333 W Lincoln Rd
Kokomo, IN 46902-8012

Phone 765-455-0085 · Fax 765-455-6839

Authorized official

John Ralph Ladd
Owner/Ceo
7654550085

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