Provider Demographics
NPI:1841822681
Name:LUDLOW, TONI L
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:L
Last Name:LUDLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2645 HEATHER FIELD LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5299
Mailing Address - Country:US
Mailing Address - Phone:801-935-0997
Mailing Address - Fax:
Practice Address - Street 1:2645 HEATHER FIELD LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5299
Practice Address - Country:US
Practice Address - Phone:801-395-0997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNONE