| Bayou Children's Dental Center | |
|
4752 Highway 311 Ste 115 Houma LA 70360-2810 | |
| (985) 868-8331 | |
| (985) 868-8332 |
| Full Name | Bayou Children's Dental Center |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4752 Highway 311 Ste 115, Houma, Louisiana |
| Authorized Official Name and Position | Claudia Anne Cavallino (DENTIST - OWNER) |
| Authorized Official Contact | 9858688331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayou Children's Dental Center 4752 Highway 311 Ste 115 Houma LA 70360-2810 Ph: (985) 868-8331 | Bayou Children's Dental Center 4752 Highway 311 Ste 115 Houma LA 70360-2810 Ph: (985) 868-8331 |
| NPI Number | 1780932830 |
|---|---|
| Provider Enumeration Date | 08/21/2012 |
| Last Update Date | 08/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780932830 | NPI | - | NPPES |
| 1853925 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 5392 (Louisiana) | Primary |
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