| Anthony Indovina A P D C | |
|
5132 Lapalco Blvd 2nd Floor Marrero LA 70072-4268 | |
| (504) 340-2401 | |
| (504) 340-2423 |
| Full Name | Anthony Indovina A P D C |
|---|---|
| Speciality | Dentist |
| Location | 5132 Lapalco Blvd, Marrero, Louisiana |
| Authorized Official Name and Position | Anthony A. Indovina (OWNER/PRESIDENT) |
| Authorized Official Contact | 5043402401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Indovina A P D C 5132 Lapalco Blvd 2nd Floor Marrero LA 70072-4268 Ph: (504) 340-2401 | Anthony Indovina A P D C 5132 Lapalco Blvd 2nd Floor Marrero LA 70072-4268 Ph: (504) 340-2401 |
| NPI Number | 1801192836 |
|---|---|
| Provider Enumeration Date | 02/09/2011 |
| Last Update Date | 02/09/2011 |
| Medicare PECOS PAC ID | 4880878503 |
|---|---|
| Medicare Enrollment ID | O20110405000187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801192836 | NPI | - | NPPES |
| 1826502 | Medicaid | LA | |
| 600034 | Other | LA | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 2650 (Louisiana) | Primary |
| Provider Name | Anthony A Indovina |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1184787921 PECOS PAC ID: 5597949214 Enrollment ID: I20110405000220 |
| Provider Name | Dane St John |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1689883589 PECOS PAC ID: 5092951566 Enrollment ID: I20160203002854 |
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