Perio Plastic & Implantology Center Of Kokomo | |
3415 S Lafountain St Suite H Kokomo IN 46902-3802 | |
(765) 455-0085 | |
Not Available |
Full Name | Perio Plastic & Implantology Center Of Kokomo |
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Speciality | Dentist - Periodontics |
Location | 3415 S Lafountain St, Kokomo, Indiana |
Authorized Official Name and Position | John Ladd (OWNER) |
Authorized Official Contact | 7654550085 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Perio Plastic & Implantology Center Of Kokomo 2333 W Lincoln Rd Kokomo IN 46902-8012 Ph: (765) 455-0085 | Perio Plastic & Implantology Center Of Kokomo 3415 S Lafountain St Suite H Kokomo IN 46902-3802 Ph: (765) 455-0085 |
NPI Number | 1982087078 |
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Provider Enumeration Date | 07/07/2015 |
Last Update Date | 07/07/2015 |
Identifier | Type | State | Issuer |
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1982087078 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223D0004X | Dentist - Dentist Anesthesiologist | 12011521A (Indiana) | Secondary |
1223P0300X | Dentist - Periodontics | 12011521A (Indiana) | Primary |
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