Organization
LADD DENTAL GROUP OF PERU, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RALPH LADD D.D.S. (OWNER/CEO)
(765) 455-0085
Entity
Organization
Contact information
Practice address
980 N BROADWAY, PERU, IN 46970-1070
(765) 473-0141
Mailing address
2333 W LINCOLN RD, KOKOMO, IN 46902-8012
(765) 455-0085
(765) 455-6839
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7486
IN
Other
Enumeration date
11/29/2010
Last updated
11/29/2010
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