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2101 W. White St., Suite 100 Anna TX 75409 | |
| (972) 924-2452 | |
| (972) 924-2459 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2101 W. White St., Suite 100, Anna, Texas |
| Authorized Official Name and Position | Jeffrey Ludlow (OWNER) |
| Authorized Official Contact | 9729242452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2101 W. White St., Suite 100 Anna TX 75409 Ph: (972) 924-2452 | 2101 W. White St., Suite 100 Anna TX 75409 Ph: (972) 924-2452 |
| NPI Number | 1013252139 |
|---|---|
| Provider Enumeration Date | 11/29/2012 |
| Last Update Date | 06/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013252139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 21693 (Texas) | Primary |
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