Organization
JOHN K LOUDERMILK INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAYLE M LAKES (OFFICE MANAGER)
(937) 382-0951
Entity
Organization
Contact information
Practice address
260 W. LOCUST ST., WILMINGTON, OH 45177
(937) 382-0951
(937) 382-0953
Mailing address
260 W. LOCUST ST., WILMINGTON, OH 45177
(937) 382-0951
(937) 382-0953
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30023348
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3100361
—
OH
Enumeration date
05/13/2011
Last updated
05/13/2011
Update your record
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