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NPI Code Detail

MEDICARE: LUDWICK DENTISTRY PC

MEDICARE: LUDWICK DENTISTRY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center25457TX

General Provider Information

NPI Number : 1427590884
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUDWICK DENTISTRY PC
Provider Business Mailing Address
First Line : 6714 N NEW BRAUNFELS AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-3848
Country : US
Telephone Number : 210-824-2401
Fax Number : 210-824-3441
Provider Business Practice Location Address
First Line : 6714 N NEW BRAUNFELS AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-3848
Country : US
Telephone Number : 210-824-2401
Fax Number : 210-824-3441
Authorized Official
Title or Position : PRESIDENT
Name : LANDON LUDWICK
Credential : DDS
Telephone Number : 817-937-3446
Provider Enumeration Date : 11/16/2016
Last Update Date : 11/16/2016

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