Provider Demographics
NPI:1427590884
Name:LUDWICK DENTISTRY PC
Entity Type:Organization
Organization Name:LUDWICK DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:LUDWICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-937-3446
Mailing Address - Street 1:6714 N NEW BRAUNFELS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3848
Mailing Address - Country:US
Mailing Address - Phone:210-824-2401
Mailing Address - Fax:210-824-3441
Practice Address - Street 1:6714 N NEW BRAUNFELS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-3848
Practice Address - Country:US
Practice Address - Phone:210-824-2401
Practice Address - Fax:210-824-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25457261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental