Provider Demographics
NPI:1275135097
Name:MODLIN & LONDRY VI DDS PLLC
Entity Type:Organization
Organization Name:MODLIN & LONDRY VI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LONDRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-575-5409
Mailing Address - Street 1:19810 W CATAWBA AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4056
Mailing Address - Country:US
Mailing Address - Phone:980-231-5995
Mailing Address - Fax:
Practice Address - Street 1:921 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-4215
Practice Address - Country:US
Practice Address - Phone:704-575-5409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty