Provider Demographics
NPI:1699741371
Name:LUDWICK, MICHELLE A (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:A
Last Name:LUDWICK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:ANGELA
Other - Last Name:LUDWICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:7949 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-8602
Mailing Address - Country:US
Mailing Address - Phone:928-317-1900
Mailing Address - Fax:
Practice Address - Street 1:7949 E 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-8602
Practice Address - Country:US
Practice Address - Phone:928-317-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD7345122300000X
AZD010999122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD010999OtherDENTAL LICENSE