| B.r. Dental Specialists Llc | |
|
3121 Maryland Ave Kenner LA 70065-4727 | |
| (504) 390-2847 | |
| Not Available |
| Full Name | B.r. Dental Specialists Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3121 Maryland Ave, Kenner, Louisiana |
| Authorized Official Name and Position | Jaclyn Duboue (MANAGING MEMBER/ DENTIST) |
| Authorized Official Contact | 5043902847 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| B.r. Dental Specialists Llc 3121 Maryland Ave Kenner LA 70065-4727 Ph: (504) 390-2847 | B.r. Dental Specialists Llc 3121 Maryland Ave Kenner LA 70065-4727 Ph: (504) 390-2847 |
| NPI Number | 1013761121 |
|---|---|
| Provider Enumeration Date | 04/15/2024 |
| Last Update Date | 04/15/2024 |
| Medicare PECOS PAC ID | 9234579160 |
|---|---|
| Medicare Enrollment ID | O20240425002873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013761121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Jaclyn Duboue |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1154409365 PECOS PAC ID: 0143660076 Enrollment ID: I20240425003096 |
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