Provider Demographics
NPI:1245616325
Name:LINDA C LUDIN DDS PC
Entity Type:Organization
Organization Name:LINDA C LUDIN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LUDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-663-9600
Mailing Address - Street 1:2 OAKWOOD PARK PLZ STE 206
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1884
Mailing Address - Country:US
Mailing Address - Phone:303-663-9600
Mailing Address - Fax:303-663-9627
Practice Address - Street 1:2 OAKWOOD PARK PLZ STE 206
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1884
Practice Address - Country:US
Practice Address - Phone:303-663-9600
Practice Address - Fax:303-663-9627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7925122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty