# LADD DENTAL GROUP OF MCCORDSVILLE, INC.

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

## Provider details

- **NPI number:** 1831610120
- **Authorized official:** MS. MARY LADD (CEO)
- **Authorized official phone:** (765) 455-0085

## Contact information

- **Practice address:** 6653 W BROADWAY, MCCORDSVILLE, IN 46055-9558
- **Practice address phone:** (765) 455-0085
- **Mailing address:** 2333 W LINCOLN RD, KOKOMO, IN 46902-8012
- **Mailing address phone:** (765) 455-0085

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | IN | Yes |

## Other

- **Enumeration date:** 06/28/2017
- **Last updated:** 08/02/2022