Provider Demographics
NPI:1952624975
Name:HIGHLANDVIEW DENTAL EXCELLENCE
Entity Type:Organization
Organization Name:HIGHLANDVIEW DENTAL EXCELLENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LUDWIG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,PC
Authorized Official - Phone:815-235-4161
Mailing Address - Street 1:3000 HIGHLAND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-6936
Mailing Address - Country:US
Mailing Address - Phone:815-235-4161
Mailing Address - Fax:815-235-1348
Practice Address - Street 1:3000 HIGHLAND VIEW DR
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-6936
Practice Address - Country:US
Practice Address - Phone:815-235-4161
Practice Address - Fax:815-235-1348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty