Periodontics Limited
NPI #1053408609 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1053408609
- Entity Type
- Organization
- Organization Name
- Periodontics Limited
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Oct 6, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 7750 W JEFFERSON BLVD
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46804-4174
- Phone
- (260) 432-0577
Authorized Official
- Name
- DR. LLOYD J. HAGEDORN, DDS, MSD
- Title
- SENIOR PARTNER
- Phone
- (260) 432-0577
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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