Cecil C Gaddis Dds., A Professional Dental Corporation | |
2709 North First Street Jena LA 71342 | |
(318) 992-6175 | |
(318) 992-6197 |
Full Name | Cecil C Gaddis Dds., A Professional Dental Corporation |
---|---|
Speciality | Dentist |
Location | 2709 North First Street, Jena, Louisiana |
Authorized Official Name and Position | Cecil Clyde Gaddis (PRESIDENT) |
Authorized Official Contact | 3189926175 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Cecil C Gaddis Dds., A Professional Dental Corporation P.o. Box 891 Jena LA 71342 Ph: (318) 992-6175 | Cecil C Gaddis Dds., A Professional Dental Corporation 2709 North First Street Jena LA 71342 Ph: (318) 992-6175 |
NPI Number | 1609238336 |
---|---|
Provider Enumeration Date | 03/22/2016 |
Last Update Date | 03/22/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609238336 | NPI | - | NPPES |
1826456 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (Louisiana) | Primary |