Provider Demographics
NPI:1932287810
Name:LADD, ALISON (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:
Last Name:LADD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 5TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1641
Mailing Address - Country:US
Mailing Address - Phone:810-406-4912
Mailing Address - Fax:810-424-6029
Practice Address - Street 1:G5399 N SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-1536
Practice Address - Country:US
Practice Address - Phone:810-785-0863
Practice Address - Fax:810-785-0865
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019102122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4901720Medicaid