| Fort Wayne Pediatric Dentistry Llc | |
|
10211 Dupont Circle Dr W Fort Wayne IN 46825-1622 | |
| (260) 490-5437 | |
| Not Available |
| Full Name | Fort Wayne Pediatric Dentistry Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 10211 Dupont Circle Dr W, Fort Wayne, Indiana |
| Authorized Official Name and Position | Kevin Ludwig (OWNER/PEDIATRIC DENTIST) |
| Authorized Official Contact | 2199296739 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Wayne Pediatric Dentistry Llc 378 Elderwood Ct Fort Wayne IN 46845-4510 Ph: (219) 929-6739 | Fort Wayne Pediatric Dentistry Llc 10211 Dupont Circle Dr W Fort Wayne IN 46825-1622 Ph: (260) 490-5437 |
| NPI Number | 1689185886 |
|---|---|
| Provider Enumeration Date | 10/16/2017 |
| Last Update Date | 10/16/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689185886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 12011802A (Indiana) | Primary |
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