Organization
ORAL SURGERY CLINIC OF LA CROSSE LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PAUL LUDINGTON D.D.S. (OWNER)
(608) 782-8193
Entity
Organization
Contact information
Practice address
2819 NATIONAL DR, ONALASKA, WI 54650-6703
(608) 782-8193
(608) 782-4517
Mailing address
2819 NATIONAL DR, ONALASKA, WI 54650-6703
(608) 782-8193
(608) 782-4517
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33757600
—
WI
01
—
835478
UNITED CONCORDIA
WI
Enumeration date
03/05/2007
Last updated
05/29/2013
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