Organization
DENTURES ONLY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R. LADD DDS (PRESIDENT)
(765) 455-0085
Entity
Organization
Contact information
Practice address
1445 W HOOSIER BLVD, STE 103, PERU, IN 46970-3727
(765) 689-7096
Mailing address
1445 W HOOSIER BLVD, STE 103, PERU, IN 46970-3727
(765) 689-7096
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7549
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100320050
—
IN
Enumeration date
05/04/2009
Last updated
05/04/2009
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