Provider Demographics
NPI:1518263193
Name:DR. PATRICIA A. LUDWIG, D.M.D.
Entity Type:Organization
Organization Name:DR. PATRICIA A. LUDWIG, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KLOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-865-5082
Mailing Address - Street 1:144 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6220
Mailing Address - Country:US
Mailing Address - Phone:610-865-5082
Mailing Address - Fax:610-865-1975
Practice Address - Street 1:144 E BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6220
Practice Address - Country:US
Practice Address - Phone:610-865-5082
Practice Address - Fax:610-865-1975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022547L1223G0001X
PADS0382431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1548342546OtherNPI
PA1831400233OtherNPI