Oral Surgery Center of Kokomo LLC

NPI #1992124879 in Kokomo, Indiana

Provider Information

NPI Number
1992124879
Entity Type
Organization
Organization Name
Oral Surgery Center of Kokomo LLC
Primary Specialty
Dentist - Oral and Maxillofacial Surgery
Enumeration Date
Apr 8, 2014
Last Updated
Apr 8, 2014

Practice Location

Address
3415 S LAFOUNTAIN ST
Address 2
SUITE H
City
Kokomo
State
Indiana
ZIP Code
46902-3802
Phone
(765) 453-7710

Authorized Official

Name
DR. JOHN LADD, DDS
Title
OWNER
Phone
(765) 453-7710

Specialties & Taxonomy Codes

Specialty
Dentist - Oral and Maxillofacial PathologyOral and Maxillofacial Pathology
Clinic/Center - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery
Dentist - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery

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Provider Name
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