Organization
DR AJLUDD DENTAL LLC
Active
Other names
DRY CREEK DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AARON JOHN LUDDINGTON DDS (OWNER)
(307) 634-9111
Entity
Organization
Contact information
Practice address
3708 E PERSHING BLVD, CHEYENNE, WY 82001-5946
(307) 634-9111
Mailing address
3708 E PERSHING BLVD, CHEYENNE, WY 82001-5946
(307) 634-9111
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295883452
—
WY
05
—
1326532441
—
WY
Enumeration date
02/11/2020
Last updated
02/11/2020
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