# LADD DENTAL GROUP OF PERU, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093017907
- **Authorized official:** JOHN RALPH LADD D.D.S. (OWNER/CEO)
- **Authorized official phone:** (765) 455-0085

## Contact information

- **Practice address:** 980 N BROADWAY, PERU, IN 46970-1070
- **Practice address phone:** (765) 473-0141
- **Mailing address:** 2333 W LINCOLN RD, KOKOMO, IN 46902-8012
- **Mailing address phone:** (765) 455-0085
- **Mailing address fax:** (765) 455-6839

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7486 | IN | Yes |

## Other

- **Enumeration date:** 11/29/2010
- **Last updated:** 11/29/2010