Organization
FORT WAYNE PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN LUDWIG DDS (OWNER/PEDIATRIC DENTIST)
(219) 929-6739
Entity
Organization
Contact information
Practice address
10211 DUPONT CIRCLE DR W, FORT WAYNE, IN 46825-1622
(260) 490-5437
Mailing address
378 ELDERWOOD CT, FORT WAYNE, IN 46845-4510
(219) 929-6739
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12011802A
IN
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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