Provider Demographics
NPI:1477750248
Name:FRANK LOUDERMILK,III,DMD, PA
Entity Type:Organization
Organization Name:FRANK LOUDERMILK,III,DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOUDERMILK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-642-5747
Mailing Address - Street 1:1522 TWO NOTCH RD SE
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-5551
Mailing Address - Country:US
Mailing Address - Phone:803-642-5747
Mailing Address - Fax:803-642-9616
Practice Address - Street 1:1522 TWO NOTCH RD SE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5551
Practice Address - Country:US
Practice Address - Phone:803-642-5747
Practice Address - Fax:803-642-9616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental