| Periodontics Limited | |
|
7750 W Jefferson Blvd Fort Wayne IN 46804-4174 | |
| (260) 432-0577 | |
| (260) 432-0578 |
| Full Name | Periodontics Limited |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 7750 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Lloyd J. Hagedorn (SENIOR PARTNER) |
| Authorized Official Contact | 2604320577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Periodontics Limited 7750 W Jefferson Blvd Fort Wayne IN 46804-4174 Ph: (260) 432-0577 | Periodontics Limited 7750 W Jefferson Blvd Fort Wayne IN 46804-4174 Ph: (260) 432-0577 |
| NPI Number | 1053408609 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053408609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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