Provider Demographics
NPI:1104861780
Name:LUDLOW, VAL EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:VAL
Middle Name:EDWARD
Last Name:LUDLOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4568 HIGHLAND DR
Mailing Address - Street 2:SUITE #370
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-4263
Mailing Address - Country:US
Mailing Address - Phone:801-277-1748
Mailing Address - Fax:801-278-5391
Practice Address - Street 1:4568 HIGHLAND DR
Practice Address - Street 2:SUITE #370
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-4263
Practice Address - Country:US
Practice Address - Phone:801-277-1748
Practice Address - Fax:801-278-5391
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT140537-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice