Provider Demographics
NPI:1396789863
Name:LUDLOW, ROBERT C (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:LUDLOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1317 OAKDALE RD
Mailing Address - Street 2:STE 210
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3361
Mailing Address - Country:US
Mailing Address - Phone:209-578-4001
Mailing Address - Fax:209-578-4320
Practice Address - Street 1:1317 OAKDALE RD
Practice Address - Street 2:STE 210
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-3361
Practice Address - Country:US
Practice Address - Phone:209-578-4001
Practice Address - Fax:209-578-4320
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA228191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice