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104 Cleco Dr Pineville LA 71360-5325 | |
| (318) 445-0343 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 104 Cleco Dr, Pineville, Louisiana |
| Authorized Official Name and Position | Cote Landry Ryland (OWNER) |
| Authorized Official Contact | 3184525576 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
104 Cleco Dr Pineville LA 71360-5325 Ph: (318) 445-0343 | 104 Cleco Dr Pineville LA 71360-5325 Ph: (318) 445-0343 |
| NPI Number | 1811363872 |
|---|---|
| Provider Enumeration Date | 08/13/2015 |
| Last Update Date | 08/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811363872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6443 (Louisiana) | Primary |
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